Provider Demographics
NPI:1144219346
Name:HIRSCH, JORDAN (MD)
Entity Type:Individual
Prefix:DR
First Name:JORDAN
Middle Name:
Last Name:HIRSCH
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 1:73 MARKET ST
Mailing Address - Street 2:SUITE 212 B
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-7602
Mailing Address - Country:US
Mailing Address - Phone:914-831-6830
Mailing Address - Fax:
Practice Address - Street 1:73 MARKET ST
Practice Address - Street 2:SUITE 212 B
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-7602
Practice Address - Country:US
Practice Address - Phone:914-831-6830
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2022-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY172513174400000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01849045Medicaid
NY4204390OtherAETNA PPO #
NY0200433OtherGHI PPO #
NY132666622OtherTAX IDENTIFICATION #
NY172513OtherHIP #
NY32F503OtherEMPIRE BCBS # (SCARSDALE)
NY32F502OtherEMPIRE BCBS # (BRONX)
NY527602OtherAETNA HMO #
NY000000029052OtherGHI HMO #
NY32F502OtherMEDICARE # BRONX
NYWP394OtherOXFORD #
NY0200433OtherGHI PPO #
NY527602OtherAETNA HMO #