Provider Demographics
NPI:1831459874
Name:HIRSCHFELD, RYAN STEVEN (MD)
Entity Type:Individual
Prefix:
First Name:RYAN
Middle Name:STEVEN
Last Name:HIRSCHFELD
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 HERITAGE LN
Mailing Address - Street 2:
Mailing Address - City:MILLER PLACE
Mailing Address - State:NY
Mailing Address - Zip Code:11764-3221
Mailing Address - Country:US
Mailing Address - Phone:978-270-0434
Mailing Address - Fax:
Practice Address - Street 1:101 NICOLLS RD FL HSC11
Practice Address - Street 2:
Practice Address - City:STONY BROOK
Practice Address - State:NY
Practice Address - Zip Code:11794-2782
Practice Address - Country:US
Practice Address - Phone:631-444-2648
Practice Address - Fax:631-444-2894
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-24
Last Update Date:2022-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIMD16643207R00000X, 208000000X
RILP02555207R00000X, 208000000X
MDD0082449207R00000X, 208000000X
NY312909208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine