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General NPI Number Information
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NPI Number | 1366752917
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Entity Type | Organization
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Legal Business Name | MEDICAL OFFICE OF HOWARD BEACH
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Dates
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Enumeration Date | 10/18/2010
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Last Update Date | 10/18/2010
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Provider Practice Location Address
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Address Line | 15640 CROSSBAY BLVD
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City | HOWARD BEACH
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State | NY
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Zip | 11414-2745
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Country | US
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Telephone | 718-529-4500
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Fax |
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Provider Business Mailing Address
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Address Line | 15640 CROSSBAY BLVD
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City | HOWARD BEACH
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State | NY
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Zip | 11414-2745
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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 | DR
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Name | DR. ALVIN T HERSHFELD IV
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Credential | DO
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Telephone | 718-529-4500
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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License Number | 009052-1
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License Number State | NY
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