MEDICARE: DR. DAVID HERSHAN MD

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	207L00000X	Anesthesiology Physician	53498	NJ
2	207L00000X	Anesthesiology Physician	172940	NY

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
3	050042106	OTHER	NJ	RAIL ROAID MEDICARE
4	050088289	OTHER	NY	RAIL ROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1740280957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DAVID HERSHAN MD

Provider Business Mailing Address
First Line	:	118 N BEDFORD RD
Second Line	:	SUITE 200
City	:	MOUNT KISCO
State	:	NY
Zip	:	10549-2553
Country	:	US
Telephone Number	:	914-666-8866
Fax Number	:	914-666-6777

Provider Business Practice Location Address
First Line	:	7600 RIVER RD
Second Line	:	PALISADES MEDICAL CENTER
City	:	NORTH BERGEN
State	:	NJ
Zip	:	07047-6217
Country	:	US
Telephone Number	:	201-854-5172
Fax Number	:

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	02/11/2009

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Directions to “ DR. DAVID HERSHAN MD” Practice Location

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