Provider Demographics
NPI:1831279934
Name:FISHBEIN, GAIL ROBYN (RDH)
Entity type:Individual
Prefix:MS
First Name:GAIL
Middle Name:ROBYN
Last Name:FISHBEIN
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:18 HILLCREST AVE APT 2B
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10308-2752
Mailing Address - Country:US
Mailing Address - Phone:718-356-1410
Mailing Address - Fax:
Practice Address - Street 1:1700 MYRTLE AVE
Practice Address - Street 2:
Practice Address - City:PLAINFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07063-1000
Practice Address - Country:US
Practice Address - Phone:908-753-6401
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-16
Last Update Date:2010-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22HI00613100124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist