Provider Demographics
NPI:1861899353
Name:FISHMAN, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:FISHMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:68A WEST PASSAIC STREET
Mailing Address - Street 2:
Mailing Address - City:ROCHELLE PARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07662
Mailing Address - Country:US
Mailing Address - Phone:201-843-3427
Mailing Address - Fax:201-843-3639
Practice Address - Street 1:68A W PASSAIC ST
Practice Address - Street 2:
Practice Address - City:ROCHELLE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07662-3216
Practice Address - Country:US
Practice Address - Phone:201-843-3427
Practice Address - Fax:201-843-3639
Is Sole Proprietor?:No
Enumeration Date:2014-11-26
Last Update Date:2021-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor