Healthcare Provider Details

I. General information

NPI: 1376512053
Provider Name (Legal Business Name): RICHARD J HERSCHAFT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/16/2006
Last Update Date: 09/15/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

203 N LIME ST
LANCASTER PA
17602-2729
US

IV. Provider business mailing address

203 N LIME ST
LANCASTER PA
17602-2729
US

V. Phone/Fax

Practice location:
  • Phone: 717-392-6267
  • Fax: 717-392-6059
Mailing address:
  • Phone: 717-392-6267
  • Fax: 717-392-6059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberMD017352E
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: