Provider Demographics
NPI:1538106232
Name:FISHBEIN, LESLIE J (MD)
Entity type:Individual
Prefix:
First Name:LESLIE
Middle Name:J
Last Name:FISHBEIN
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:PO BOX 465
Mailing Address - Street 2:BERKSHIRE MEDICAL CENTER
Mailing Address - City:PITTSFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01202-0465
Mailing Address - Country:US
Mailing Address - Phone:413-442-5600
Mailing Address - Fax:
Practice Address - Street 1:55 NORTH ST
Practice Address - Street 2:STE 213
Practice Address - City:PITTSFIELD
Practice Address - State:MA
Practice Address - Zip Code:01201-5874
Practice Address - Country:US
Practice Address - Phone:413-442-5600
Practice Address - Fax:888-371-3987
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2020-11-22
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MA738272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA110051203AMedicaid