Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YX0905X | Otolaryngology/Facial Plastic Surgery | 138505 | NY |
NPI | 1699885483 |
---|---|
Provider Name | Sheldon Paul Hersh |
First Address | Forest Hills, NY 11375-4946 |
Second Address | Forest Hills, NY 11375-4946 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00744234 | (05) | NY |
B80496 | (02) |