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General NPI Number Information
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NPI Number | 1326081001
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Entity Type | Individual
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Provider Name | JERRY HERSH MD
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Gender | Male
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Dates
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Enumeration Date | 06/13/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VICENZA HEALTH CLINIC VICENZA HEALTH CLINIC, VICENZA, ITALY
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City | APO AE
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State | NY
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Zip | 09630-0016
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Country | US
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Telephone | 44-471-8301
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Fax | 44-471-8210
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Provider Business Mailing Address
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Address Line | CMR 427 BOX 1559
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City | APO AE
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State | NY
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Zip | 09630-0016
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD2004-0069
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License Number State | NM
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