MEDICARE: MS. ALLA FISHMAN DO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	OS012044	PA
2	207V00000X	Obstetrics & Gynecology Physician	OS012044	PA

General Provider Information

NPI Number	:	1710967716
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ALLA FISHMAN DO

Provider Business Mailing Address
First Line	:	1904 COUNTY LINE ROAD
Second Line	:
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-1738
Country	:	US
Telephone Number	:	215-322-3022
Fax Number	:	215-355-9155

Provider Business Practice Location Address
First Line	:	1904 COUNTY LINE ROAD
Second Line	:
City	:	HUNTINGDON VALLEY
State	:	PA
Zip	:	19006-1738
Country	:	US
Telephone Number	:	215-322-3022
Fax Number	:	215-355-9155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/18/2006
Last Update Date	:	01/22/2010

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