Provider Demographics
NPI:1831108356
Name:HIRSCHBERG, ROBERT (DO)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:
Last Name:HIRSCHBERG
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 1:520 FRANKLIN AVENUE
Mailing Address - Street 2:SUITE 212
Mailing Address - City:GARDEN CITY
Mailing Address - State:NY
Mailing Address - Zip Code:11530
Mailing Address - Country:US
Mailing Address - Phone:516-873-6269
Mailing Address - Fax:516-873-6306
Practice Address - Street 1:520 FRANKLIN AVENUE
Practice Address - Street 2:SUITE 212
Practice Address - City:GARDEN CITY
Practice Address - State:NY
Practice Address - Zip Code:11530
Practice Address - Country:US
Practice Address - Phone:516-873-6269
Practice Address - Fax:516-873-6306
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY204288207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02052826Medicaid
G89956Medicare UPIN
NY02052826Medicaid