MEDICARE: DR. HORACE HERBSMAN M.D.

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
1	208600000X	Surgery Physician	075328	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124025341
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. HORACE HERBSMAN M.D.

Provider Business Mailing Address
First Line	:	40 CENTER CT
Second Line	:
City	:	ROSLYN HEIGHTS
State	:	NY
Zip	:	11577-1977
Country	:	US
Telephone Number	:	516-621-7960
Fax Number	:	516-621-7962

Provider Business Practice Location Address
First Line	:	327 BEACH 19TH ST
Second Line	:
City	:	FAR ROCKAWAY
State	:	NY
Zip	:	11691-4423
Country	:	US
Telephone Number	:	718-868-7255
Fax Number	:	718-869-8284

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/01/2005
Last Update Date	:	07/08/2007

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