MEDICARE: DAVID LAWRENCE HERMAN M.D.

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	207RI0200X	Infectious Disease Physician	175782	NY
2	207RI0200X	Infectious Disease Physician	175782-1	NY
3	207R00000X	Internal Medicine Physician	175782	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1073505723
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID LAWRENCE HERMAN M.D.

Provider Business Mailing Address
First Line	:	PO BOX 14890
Second Line	:
City	:	ALBANY
State	:	NY
Zip	:	12212-4890
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	421 WEST COLUMBIA STREET
Second Line	:
City	:	COHOES
State	:	NY
Zip	:	12047-2217
Country	:	US
Telephone Number	:	518-238-4152
Fax Number	:

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	11/21/2024

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