Healthcare Provider Details

I. General information

NPI: 1841428539
Provider Name (Legal Business Name): OREN TZVI HERMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2009
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

475 SEAVIEW AVE
STATEN ISLAND NY
10305-3436
US

IV. Provider business mailing address

2800 MARCUS AVE
NEW HYDE PARK NY
11042-1113
US

V. Phone/Fax

Practice location:
  • Phone: 718-226-9000
  • Fax:
Mailing address:
  • Phone: 516-622-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number274786
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: