Provider Demographics
NPI:1093792491
Name:HIRSHBERG, LAUREN DANIELLE (DC)
Entity Type:Individual
Prefix:DR
First Name:LAUREN
Middle Name:DANIELLE
Last Name:HIRSHBERG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:426 STATE RT 515
Mailing Address - Street 2:
Mailing Address - City:VERNON
Mailing Address - State:NJ
Mailing Address - Zip Code:07462-3027
Mailing Address - Country:US
Mailing Address - Phone:973-764-5666
Mailing Address - Fax:973-764-5778
Practice Address - Street 1:426 STATE RT 515
Practice Address - Street 2:
Practice Address - City:VERNON
Practice Address - State:NJ
Practice Address - Zip Code:07462-3027
Practice Address - Country:US
Practice Address - Phone:973-764-5666
Practice Address - Fax:973-764-5778
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00452700111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ865253OtherAETNA
NJP400698OtherOXFORD
NJP400698OtherOXFORD
NJPA128848Medicare ID - Type Unspecified