Provider Demographics
NPI:1417195082
Name:HIRSCHMAN, ALLISTER F (PA)
Entity Type:Individual
Prefix:
First Name:ALLISTER
Middle Name:F
Last Name:HIRSCHMAN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:ALLISON
Other - Middle Name:
Other - Last Name:HIRSCHMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:20 YORK STREET YALE-NEW HAVEN HOSPITAL
Mailing Address - Street 2:ADULT EMERGENCY DEPARTMENT
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06504-8900
Mailing Address - Country:US
Mailing Address - Phone:203-688-2222
Mailing Address - Fax:
Practice Address - Street 1:20 YORK STREET YALE-NEW HAVEN HOSPITAL
Practice Address - Street 2:ADULT EMERGENCY DEPARTMENT
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06504-8900
Practice Address - Country:US
Practice Address - Phone:203-688-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-04
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT002182363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
CTMH1861992OtherDEA