MEDICARE: DR. DAVID S. KIRSCH 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	207W00000X	Ophthalmology Physician	180068	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	:	1417934035
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID S. KIRSCH M.D.

Provider Business Mailing Address
First Line	:	123 GROVE AVE
Second Line	:	SUITE 214
City	:	CEDARHURST
State	:	NY
Zip	:	11516-2322
Country	:	US
Telephone Number	:	516-374-6900
Fax Number	:	516-374-8632

Provider Business Practice Location Address
First Line	:	123 GROVE AVE
Second Line	:	SUITE 214
City	:	CEDARHURST
State	:	NY
Zip	:	11516-2322
Country	:	US
Telephone Number	:	516-374-6900
Fax Number	:	516-374-8632

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

Provider Enumeration Date	:	12/23/2005
Last Update Date	:	11/01/2010

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