Provider Demographics
NPI:1902833544
Name:HIRSCHHORN, BRAD DOUGLAS (DC)
Entity Type:Individual
Prefix:DR
First Name:BRAD
Middle Name:DOUGLAS
Last Name:HIRSCHHORN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 HUNTINGDON PIKE
Mailing Address - Street 2:
Mailing Address - City:ROCKLEDGE
Mailing Address - State:PA
Mailing Address - Zip Code:19046-4445
Mailing Address - Country:US
Mailing Address - Phone:215-663-8555
Mailing Address - Fax:
Practice Address - Street 1:320 HUNTINGDON PIKE
Practice Address - Street 2:
Practice Address - City:ROCKLEDGE
Practice Address - State:PA
Practice Address - Zip Code:19046-4445
Practice Address - Country:US
Practice Address - Phone:215-663-8555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADC0003718-L111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0100337000Other10-DIGIT HMO ID