Provider Demographics
NPI:1760425649
Name:HERSHEY, JOEL E (MD)
Entity Type:Individual
Prefix:DR
First Name:JOEL
Middle Name:E
Last Name:HERSHEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:JOEL
Other - Middle Name:ERWIN
Other - Last Name:HERSHEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:1 KINGS HWY
Mailing Address - Street 2:
Mailing Address - City:HAUPPAUGE
Mailing Address - State:NY
Mailing Address - Zip Code:11788-4216
Mailing Address - Country:US
Mailing Address - Phone:631-348-4900
Mailing Address - Fax:631-348-0273
Practice Address - Street 1:1 KINGS HWY
Practice Address - Street 2:
Practice Address - City:HAUPPAUGE
Practice Address - State:NY
Practice Address - Zip Code:11788-4216
Practice Address - Country:US
Practice Address - Phone:631-348-4900
Practice Address - Fax:631-348-0273
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY124745208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02959WMedicare ID - Type Unspecified
NYC08961Medicare UPIN
NY467Z21Medicare ID - Type Unspecified