Provider Demographics
NPI:1679555320
Name:HIRSCH, WILLIAM S (DO)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:S
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1077 RIVER RD
Mailing Address - Street 2:STE 1
Mailing Address - City:WASHINGTON CROSSING
Mailing Address - State:PA
Mailing Address - Zip Code:18977-1449
Mailing Address - Country:US
Mailing Address - Phone:215-208-3358
Mailing Address - Fax:
Practice Address - Street 1:1077 RIVER RD
Practice Address - Street 2:STE 1
Practice Address - City:WASHINGTON CROSSING
Practice Address - State:PA
Practice Address - Zip Code:18977-1449
Practice Address - Country:US
Practice Address - Phone:267-685-6367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-17
Last Update Date:2019-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS007728L207RC0000X, 207RC0000X
NJ25MB06924000207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7994206Medicaid
PA0015270330008Medicaid
PA0015270330008Medicaid
232571699OtherTIN
462009036OtherTIN
NJ028303DSJMedicare ID - Type Unspecified
462009036OtherTIN
PA0015270330008Medicaid