Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | A149931 | CA |
NPI | 1316253545 |
---|---|
Provider Name | Melissa Hersh |
First Address | Oakland, CA 94611-5933 |
Second Address | Brooklyn, NY 11219 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2010 |
Last Update Date | 20/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
390200000X | STUDENT, HEALTHCARE (01) | NY |