Provider Demographics
NPI:1881647063
Name:HERSHCOPF, RICHARD JAY (MD)
Entity Type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:JAY
Last Name:HERSHCOPF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:2 DEAN DR
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TENAFLY
Mailing Address - State:NJ
Mailing Address - Zip Code:07670-2765
Mailing Address - Country:US
Mailing Address - Phone:201-871-4680
Mailing Address - Fax:201-871-3815
Practice Address - Street 1:2 DEAN DR
Practice Address - Street 2:2ND FLOOR
Practice Address - City:TENAFLY
Practice Address - State:NJ
Practice Address - Zip Code:07670-2765
Practice Address - Country:US
Practice Address - Phone:201-871-4680
Practice Address - Fax:201-871-3815
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-18
Last Update Date:2010-08-16
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMA541842080P0205X
NY1462752080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ517707Medicaid
NJ517707Medicaid
NJHE776429Medicare ID - Type Unspecified