Provider Demographics
NPI:1942265657
Name:HERTZ, ARNOLD MARC (DPM)
Entity Type:Individual
Prefix:DR
First Name:ARNOLD
Middle Name:MARC
Last Name:HERTZ
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:650 CENTRAL AVE
Mailing Address - Street 2:SUITE C
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-2301
Mailing Address - Country:US
Mailing Address - Phone:516-295-3338
Mailing Address - Fax:516-295-3123
Practice Address - Street 1:650 CENTRAL AVE
Practice Address - Street 2:SUITE C
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-2301
Practice Address - Country:US
Practice Address - Phone:516-295-3338
Practice Address - Fax:516-295-3123
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN2948213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T31919Medicare UPIN
NYP49993Medicare ID - Type UnspecifiedBLUE CROSS MEDEICARE