Provider Demographics
NPI:1164673125
Name:HIRSCH, MARSHALL (RPH)
Entity Type:Individual
Prefix:MR
First Name:MARSHALL
Middle Name:
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:599 CONVENT ROAD
Mailing Address - Street 2:PHARMACY DEPT
Mailing Address - City:ORANGEBURG
Mailing Address - State:NY
Mailing Address - Zip Code:10962
Mailing Address - Country:US
Mailing Address - Phone:845-680-4061
Mailing Address - Fax:
Practice Address - Street 1:599 CONVENT ROAD
Practice Address - Street 2:PHARMACY DEPT
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962
Practice Address - Country:US
Practice Address - Phone:845-680-4061
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-08
Last Update Date:2008-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY031699183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist