Provider Demographics
NPI:1477742377
Name:RONNIE A. HERSHMAN, M.D., PLLC
Entity Type:Organization
Organization Name:RONNIE A. HERSHMAN, M.D., PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL BILLING
Authorized Official - Prefix:
Authorized Official - First Name:VAL
Authorized Official - Middle Name:
Authorized Official - Last Name:TRICARICO
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:516-869-5400
Mailing Address - Street 1:1 HOLLOW LN
Mailing Address - Street 2:SUITE 103
Mailing Address - City:NEW HYDE PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11042-1215
Mailing Address - Country:US
Mailing Address - Phone:516-869-5400
Mailing Address - Fax:
Practice Address - Street 1:1 HOLLOW LN
Practice Address - Street 2:SUITE 103
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1215
Practice Address - Country:US
Practice Address - Phone:516-869-5400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2007-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155932207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYWEQ361Medicare PIN