Provider Demographics
NPI:1104830447
Name:HERZ, NATASHA (MD)
Entity Type:Individual
Prefix:DR
First Name:NATASHA
Middle Name:
Last Name:HERZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:NATASHA
Other - Middle Name:
Other - Last Name:HERZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:611 ROCKVILLE PIKE STE 120
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-1178
Mailing Address - Country:US
Mailing Address - Phone:240-328-6812
Mailing Address - Fax:240-499-8291
Practice Address - Street 1:611 ROCKVILLE PIKE STE 120
Practice Address - Street 2:
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-1178
Practice Address - Country:US
Practice Address - Phone:240-328-6812
Practice Address - Fax:240-499-8291
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0065570207W00000X
TXM4150207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDI69958Medicare UPIN
MD020883S58Medicare PIN