Provider Demographics
NPI:1477600526
Name:HIRSCHFELD, ROY ALLAN (EDS)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:ALLAN
Last Name:HIRSCHFELD
Suffix:
Gender:M
Credentials:EDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 CAMBRIDGE TER
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:NJ
Mailing Address - Zip Code:07081-2601
Mailing Address - Country:US
Mailing Address - Phone:973-379-4393
Mailing Address - Fax:973-379-6866
Practice Address - Street 1:150 JFK PARKWAY
Practice Address - Street 2:SUITE 100
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07083
Practice Address - Country:US
Practice Address - Phone:973-379-4393
Practice Address - Fax:973-379-6866
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37RC00203400101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health