Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 030187 | NY |
NPI | 1548447493 |
---|---|
Provider Name | Dr. Kenneth H Hirsch |
First Address | Levittown, NY 11756 |
Second Address | Levittown, NY 11756 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/01/2008 |
Last Update Date | 25/10/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U44982 | (02) | NY |