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General NPI Number Information
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NPI Number | 1922538644
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Entity Type | Individual
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Provider Name | DYLAN HERSHKOWITZ MD
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Gender | Male
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Dates
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Enumeration Date | 06/14/2017
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Last Update Date | 06/23/2025
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Provider Practice Location Address
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Address Line | 145 PINE HAVEN SHORES RD STE 1191
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City | SHELBURNE
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State | VT
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Zip | 05482-7821
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Country | US
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Telephone | 802-899-0124
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Fax | 855-268-5333
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Provider Business Mailing Address
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Address Line | 420 SCRABBLETOWN RD STE A
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City | NORTH KINGSTOWN
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State | RI
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Zip | 02852-3638
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Country | US
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Telephone | 401-258-5419
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Fax | 855-268-5333
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 323968
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD17074
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License Number State | RI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | LP04018
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License Number State | RI
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Taxonomy #4
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 042.0017013
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License Number State | VT
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