Provider Demographics
NPI:1306950233
Name:FISHKIND, PERRY N (MD)
Entity type:Individual
Prefix:
First Name:PERRY
Middle Name:N
Last Name:FISHKIND
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 OLD TAPPAN ROAD
Mailing Address - Street 2:OLD TAPPAN ROAD
Mailing Address - City:OLD TAPPAN
Mailing Address - State:NJ
Mailing Address - Zip Code:07675
Mailing Address - Country:US
Mailing Address - Phone:201-666-1000
Mailing Address - Fax:201-666-7610
Practice Address - Street 1:215 OLD TAPPAN ROAD
Practice Address - Street 2:
Practice Address - City:OLD TAPPAN
Practice Address - State:NJ
Practice Address - Zip Code:07675
Practice Address - Country:US
Practice Address - Phone:201-666-1000
Practice Address - Fax:201-666-7610
Is Sole Proprietor?:No
Enumeration Date:2006-08-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA63850208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
571691OtherEMPIRE HLTHCR
5752717004OtherCIGNA
010063850NJ01OtherANTHEM HEALTH
13335OtherUSHC
221941517010OtherPRUDENTIAL
7555049OtherAETNA
1830611OtherUNITED HLTHCR
24104OtherMASTERCARE
NJ8397601Medicaid
938894OtherREFERRAL
IK3362OtherHEALTHNET
P670449OtherOXFORD
59089OtherAMERIGROUP
1830611OtherUNITED HLTHCR