Provider Demographics
NPI:1205872207
Name:HITSCHERICH, ROBERT (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HITSCHERICH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4277 HEMPSTEAD TPKE
Mailing Address - Street 2:SUITE 209
Mailing Address - City:BETHPAGE
Mailing Address - State:NY
Mailing Address - Zip Code:11714-5709
Mailing Address - Country:US
Mailing Address - Phone:516-731-7770
Mailing Address - Fax:516-731-7052
Practice Address - Street 1:789 OLD COUNTRY RD
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4907
Practice Address - Country:US
Practice Address - Phone:516-433-3600
Practice Address - Fax:516-433-9490
Is Sole Proprietor?:No
Enumeration Date:2006-06-20
Last Update Date:2008-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY181121207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYAP978OtherOXFORD
NY01640784Medicaid
NY0C6259OtherHEALTHNET
NY110111686OtherRAILROAD MEDICARE
NY0C6259OtherHEALTHNET
NY01640784Medicaid