Provider Demographics
NPI:1235107327
Name:HERSHKOWITZ, SID J (PT)
Entity Type:Individual
Prefix:MR
First Name:SID
Middle Name:J
Last Name:HERSHKOWITZ
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 IRONWOOD DR
Mailing Address - Street 2:
Mailing Address - City:HIGHLAND MILLS
Mailing Address - State:NY
Mailing Address - Zip Code:10930-2802
Mailing Address - Country:US
Mailing Address - Phone:845-928-1678
Mailing Address - Fax:
Practice Address - Street 1:3141 ROUTE 9W
Practice Address - Street 2:SUITE 400
Practice Address - City:NEW WINDSOR
Practice Address - State:NY
Practice Address - Zip Code:12553-6709
Practice Address - Country:US
Practice Address - Phone:845-565-5943
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY012617225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist