MEDICARE: DR. BRIAN HIRSCHFIELD DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	041763	NY

General Provider Information

NPI Number	:	1053411827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN HIRSCHFIELD DDS

Provider Business Mailing Address
First Line	:	6003 BIG TREE RD
Second Line	:	PO BOX 80
City	:	LIVONIA
State	:	NY
Zip	:	14487
Country	:	US
Telephone Number	:	585-346-3028
Fax Number	:

Provider Business Practice Location Address
First Line	:	6003 BIG TREE RD
Second Line	:
City	:	LIVONIA
State	:	NY
Zip	:	14487
Country	:	US
Telephone Number	:	585-346-3028
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/22/2006
Last Update Date	:	07/08/2007

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