Provider Demographics
NPI:1790780948
Name:KIRSH, ISIDORE MICHAEL (PHD)
Entity Type:Individual
Prefix:MR
First Name:ISIDORE
Middle Name:MICHAEL
Last Name:KIRSH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:250 RTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8023
Mailing Address - Country:US
Mailing Address - Phone:732-818-3620
Mailing Address - Fax:732-818-3663
Practice Address - Street 1:83 RTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-6405
Practice Address - Country:US
Practice Address - Phone:732-818-3610
Practice Address - Fax:732-818-3663
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-15
Last Update Date:2024-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MG00067800237600000X
NJ41YA00032200231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
No231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ4899827OtherGHI
NJ5815540OtherAETNA
NJ7297705OtherCIGNA PPO
NJVS074OtherOXFORD
NJ7297705003OtherCIGNA HMO
NJ978761OtherHEALTHNET
NJ223150885OtherHORIZONBCBSNJ
NJ60003396OtherHORIZONMERCY
NJMOW471OtherEMPIRE BCBS
NJ752368Medicare ID - Type UnspecifiedGROUP IDENTIFIER
NJVS074OtherOXFORD