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NPI Code Detail

MEDICARE: MADELINE HERSHENOV

MEDICARE: MADELINE HERSHENOV
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
1104100000XSocial Worker096756

General Provider Information

NPI Number : 1063926855
Entity Type Code : Individual
Provider Name (Legal Business Name) : MADELINE HERSHENOV
Provider Business Mailing Address
First Line : 6023 FORT HAMILTON PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4814
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 6023 FORT HAMILTON PKWY
Second Line :
City : BROOKLYN
State : NY
Zip : 11219-4814
Country : US
Telephone Number : 718-686-3400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/01/2017
Last Update Date : 12/01/2017

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