Provider Demographics
NPI:1851483614
Name:HERSH, BONNIE P (MD)
Entity Type:Individual
Prefix:
First Name:BONNIE
Middle Name:P
Last Name:HERSH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:133 BROOKLINE AVE
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02215-3904
Mailing Address - Country:US
Mailing Address - Phone:617-421-1020
Mailing Address - Fax:617-421-1063
Practice Address - Street 1:133 BROOKLINE AVE
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-3904
Practice Address - Country:US
Practice Address - Phone:617-421-1020
Practice Address - Fax:617-421-1063
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA807862084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0018223OtherNEIGHBORHOOD HEALTH PLAN
MA3166791Medicaid
MA8326592-002OtherCIGNA
MAP00026164OtherMEDICARE RAILROAD
MAPK161OtherHARVARD PILGRIM
MA080786OtherTUFTS HEALTH PLAN
MAJ17853OtherBLUE CROSS
MAJ17853OtherBLUE CROSS
MAP00026164OtherMEDICARE RAILROAD