Provider Demographics
NPI:1144512104
Name:RICKIE PENSTEIN-HIRT,M.D.,PLLC
Entity type:Organization
Organization Name:RICKIE PENSTEIN-HIRT,M.D.,PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:RICKIE
Authorized Official - Middle Name:
Authorized Official - Last Name:PENSTEIN-HIRT
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:917-453-3726
Mailing Address - Street 1:1157 BROADWAY
Mailing Address - Street 2:SUITE3
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2325
Mailing Address - Country:US
Mailing Address - Phone:516-569-9100
Mailing Address - Fax:516-569-9200
Practice Address - Street 1:1157 BROADWAY
Practice Address - Street 2:SUITE3
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2325
Practice Address - Country:US
Practice Address - Phone:516-569-9100
Practice Address - Fax:516-569-9200
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-10
Last Update Date:2011-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199142207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologyGroup - Single Specialty