Provider Demographics
NPI:1376717058
Name:HIRSCH, DAVID JONATHAN (DC)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:JONATHAN
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:74 E MAPLE AVE
Mailing Address - Street 2:
Mailing Address - City:SUFFERN
Mailing Address - State:NY
Mailing Address - Zip Code:10901-5610
Mailing Address - Country:US
Mailing Address - Phone:845-504-0743
Mailing Address - Fax:
Practice Address - Street 1:74 E MAPLE AVE
Practice Address - Street 2:
Practice Address - City:SUFFERN
Practice Address - State:NY
Practice Address - Zip Code:10901-5610
Practice Address - Country:US
Practice Address - Phone:845-504-0743
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-15
Last Update Date:2008-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX008897111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor