Provider Demographics
NPI:1538278312
Name:HERSHENBAUM, ESTHER (MD)
Entity type:Individual
Prefix:MRS
First Name:ESTHER
Middle Name:
Last Name:HERSHENBAUM
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:PO BOX 1546
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD CLIFFS
Mailing Address - State:NJ
Mailing Address - Zip Code:07632
Mailing Address - Country:US
Mailing Address - Phone:201-945-6500
Mailing Address - Fax:201-945-1157
Practice Address - Street 1:663 PALISADE AVENUE
Practice Address - Street 2:SUITE 101
Practice Address - City:CLIFFSIDE PARK
Practice Address - State:NJ
Practice Address - Zip Code:07010
Practice Address - Country:US
Practice Address - Phone:201-945-6500
Practice Address - Fax:201-945-1157
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2014-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA04552000207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ02E121OtherEMPIRE NY
NJ0594202Medicaid
NJ2123609OtherUS HEALTHCARE
C53682Medicare UPIN
NJHE167543Medicare PIN