MEDICARE: ELIYAKIM HERSHKOP

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	207R00000X	Internal Medicine Physician	325156	NY

General Provider Information

NPI Number	:	1134748940
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIYAKIM HERSHKOP

Provider Business Mailing Address
First Line	:	1237 E 18TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11230-5311
Country	:	US
Telephone Number	:	215-733-9726
Fax Number	:

Provider Business Practice Location Address
First Line	:	4801 10TH AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11219
Country	:	US
Telephone Number	:	718-283-6000
Fax Number	:

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

Provider Enumeration Date	:	04/11/2020
Last Update Date	:	12/20/2023

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