Provider Demographics
NPI:1417028838
Name:NATASHA L HERZ MD PA
Entity Type:Organization
Organization Name:NATASHA L HERZ MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARGARET
Authorized Official - Middle Name:T
Authorized Official - Last Name:NELSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:301-881-5701
Mailing Address - Street 1:4701 RANDOLPH RD
Mailing Address - Street 2:G2
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-2259
Mailing Address - Country:US
Mailing Address - Phone:301-881-5701
Mailing Address - Fax:301-881-5460
Practice Address - Street 1:4701 RANDOLPH RD
Practice Address - Street 2:G2
Practice Address - City:ROCKVILLE
Practice Address - State:MD
Practice Address - Zip Code:20852-2259
Practice Address - Country:US
Practice Address - Phone:301-881-5701
Practice Address - Fax:301-881-5460
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-10
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD196558Medicare PIN