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NPI Code Detail

MEDICARE: BARRY G HERSTIK D.P.M

MEDICARE: BARRY G HERSTIK D.P.M
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
1207X00000XOrthopaedic Surgery PhysicianN004973NY
2213ES0103XFoot & Ankle Surgery PodiatristMD2186NJ
3213ES0131XFoot Surgery PodiatristN004973NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1467560532
Entity Type Code : Individual
Provider Name (Legal Business Name) : BARRY G HERSTIK D.P.M
Provider Business Mailing Address
First Line : 370 GRAND AVE
Second Line : SUITE 101
City : ENGLEWOOD
State : NJ
Zip : 07631-4109
Country : US
Telephone Number : 201-816-8778
Fax Number : 201-816-9009
Provider Business Practice Location Address
First Line : 934 MANHATTAN AVE
Second Line :
City : BROOKLYN
State : NY
Zip : 11222-5928
Country : US
Telephone Number : 718-389-8585
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2006
Last Update Date : 04/15/2021

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