MEDICARE: DR. MELANIE HERZFELD AU.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	231H00000X	Audiologist	000134	NY
2	237600000X	Audiologist-Hearing Aid Fitter	14000002070	NY
3	231HA2500X	Assistive Technology Supplier Audiologist	000134	NY
4	231HA2400X	Assistive Technology Practitioner Audiologist	000134	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	200093420	OTHER	NY	VARIOUS INSURANCES
2	930	OTHER	NY	VYTRA
3	71782	OTHER	NY	UNITEDHEALTHCARE
4	M72841	OTHER	NY	EMPIRE BLUE CROSS
5	5924241	OTHER	NY	AETNA
6	390014	OTHER	NY	CONNECTICARE
7	3C6565	OTHER	NY	HEALTHNET
8	P885877	OTHER	NY	OXFORD
9	000134	OTHER	NY	HIP

General Provider Information

NPI Number	:	1568464865
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELANIE HERZFELD AU.D.

Provider Business Mailing Address
First Line	:	113 CROSSWAYS PARK DR
Second Line	:	SUITE 101
City	:	WOODBURY
State	:	NY
Zip	:	11797-2044
Country	:	US
Telephone Number	:	516-364-0011
Fax Number	:	516-364-0013

Provider Business Practice Location Address
First Line	:	113 CROSSWAYS PARK DR
Second Line	:	SUITE 101
City	:	WOODBURY
State	:	NY
Zip	:	11797-2044
Country	:	US
Telephone Number	:	516-364-0011
Fax Number	:	516-364-0013

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

Provider Enumeration Date	:	06/01/2005
Last Update Date	:	03/31/2014

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