Provider Demographics
NPI:1376512053
Name:HERSCHAFT, RICHARD J (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:J
Last Name:HERSCHAFT
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 1:203 N LIME ST
Mailing Address - Street 2:
Mailing Address - City:LANCASTER
Mailing Address - State:PA
Mailing Address - Zip Code:17602-2729
Mailing Address - Country:US
Mailing Address - Phone:717-392-6267
Mailing Address - Fax:717-392-6059
Practice Address - Street 1:203 N LIME ST
Practice Address - Street 2:
Practice Address - City:LANCASTER
Practice Address - State:PA
Practice Address - Zip Code:17602-2729
Practice Address - Country:US
Practice Address - Phone:717-392-6267
Practice Address - Fax:717-392-6059
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2011-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD017352E207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA027604OtherBLUE SHIELD
PA5003OtherH.AMERICA H.ASSURANCE
PA07003587OtherRR MEDICARE
PA01410501OtherCAP. BLUE CROSS
PA0562896OtherAETNA
PA5003OtherH.AMERICA H.ASSURANCE