Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MAO79153 | NJ |
NPI | 1033313366 |
---|---|
Provider Name | Dr. Alissa Loren Bennett Hersh |
First Address | Bronx, NY 10463-1117 |
Second Address | Bronx, NY 10463-1117 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/06/2007 |
Last Update Date | 08/07/2007 |