MEDICARE: JONATHAN M. HIRSCH, MDPC

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	207LP2900X	Pain Medicine (Anesthesiology) Physician	182827	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier Issuer
1	5301223	OTHER	GHI
2	P1922953	OTHER	OXFORD
3	HJ2827	OTHER	ATLANTIS
4	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
5	182827B26	OTHER	HEALTHFIRST

General Provider Information

NPI Number	:	1326081506
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	JONATHAN M. HIRSCH, MDPC

Provider Business Mailing Address
First Line	:	1861 E 22ND ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1526
Country	:	US
Telephone Number	:	718-376-5177
Fax Number	:	718-376-1525

Provider Business Practice Location Address
First Line	:	2136 OCEAN AVE
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11229-1406
Country	:	US
Telephone Number	:	718-376-5177
Fax Number	:	718-376-1525

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. JONATHAN MARTIN HIRSCH
Credential	:	MD
Telephone Number	:	718-376-5177

Provider Enumeration Date	:	06/14/2006
Last Update Date	:	07/23/2012

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