Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0131X | Foot Surgery | 003341 | NY |
NPI | 1063497360 |
---|---|
Provider Name | Dr. Peter J Hirschhorn |
First Address | Jericho, NY 11753-0273 |
Second Address | Bronx, NY 10467-2727 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/12/2005 |
Last Update Date | 26/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00659090 | (05) | NY |
P00292966 | RAILROAD MEDICARE (01) | GA |
T84734 | (02) | NY |