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NPI Code Detail

MEDICARE: KENNETH MICHAEL HIRSCH MD

MEDICARE: KENNETH MICHAEL HIRSCH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208000000XPediatrics Physician25MA04122800NJ

General Provider Information

NPI Number : 1023015880
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH MICHAEL HIRSCH MD
Provider Business Mailing Address
First Line : 25 HOMESTEAD DR
Second Line : STE H
City : COLUMBUS
State : NJ
Zip : 08022-1005
Country : US
Telephone Number : 609-424-0340
Fax Number : 609-298-7452
Provider Business Practice Location Address
First Line : 25 HOMESTEAD DR
Second Line : STE H
City : COLUMBUS
State : NJ
Zip : 08022-1005
Country : US
Telephone Number : 609-424-0340
Fax Number : 609-298-7452
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/07/2005
Last Update Date : 07/08/2007

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