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NPI Code Detail

MEDICARE: RONALD DAVID HERSHCOPF

MEDICARE:   RONALD DAVID HERSHCOPF
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
1363A00000XPhysician Assistant023020NY

General Provider Information

NPI Number : 1558830950
Entity Type Code : Individual
Provider Name (Legal Business Name) : RONALD DAVID HERSHCOPF
Provider Business Mailing Address
First Line : 1651 PRESIDENT ST
Second Line :
City : BROOKLYN
State : NY
Zip : 11213-4926
Country : US
Telephone Number : 860-559-8294
Fax Number :
Provider Business Practice Location Address
First Line : 111 E 210TH ST
Second Line :
City : BRONX
State : NY
Zip : 10467-2401
Country : US
Telephone Number : 860-559-8294
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2018
Last Update Date : 11/15/2018

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Directions to “ RONALD DAVID HERSHCOPF ” Practice Location

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