Provider Demographics
NPI:1063750651
Name:HERSHKOWITZ, NATALIA (MD)
Entity type:Individual
Prefix:
First Name:NATALIA
Middle Name:
Last Name:HERSHKOWITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:480 BUFFALO CT
Mailing Address - Street 2:
Mailing Address - City:WEST NEW YORK
Mailing Address - State:NJ
Mailing Address - Zip Code:07093-8320
Mailing Address - Country:US
Mailing Address - Phone:917-510-5127
Mailing Address - Fax:646-572-8765
Practice Address - Street 1:480 BUFFALO CT
Practice Address - Street 2:
Practice Address - City:WEST NEW YORK
Practice Address - State:NJ
Practice Address - Zip Code:07093-8320
Practice Address - Country:US
Practice Address - Phone:917-510-5127
Practice Address - Fax:646-572-8765
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-16
Last Update Date:2017-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
282N00000X
NY283750-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No282N00000XHospitalsGeneral Acute Care Hospital