=====================================================
General NPI Number Information
=====================================================
NPI Number | 1427183201
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | GERALD M FISHBEIN PHD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/22/2007
-----------------------------------------------------
Last Update Date | 01/18/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 315 CENTRAL PARK WEST 10
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10025-7655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-712-0263
-----------------------------------------------------
Fax | 212-712-0263
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 315 CENTRAL PARK WEST 10
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10025-7655
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 212-712-0263
-----------------------------------------------------
Fax | 212-712-0263
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 2293
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 103TC0700X
-----------------------------------------------------
Taxonomy Name | Clinical Psychologist
-----------------------------------------------------
License Number | 35S100018400
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------