Provider Demographics
NPI:1972505485
Name:HERRERA, ARYEH L (MD, FACS)
Entity Type:Individual
Prefix:DR
First Name:ARYEH
Middle Name:L
Last Name:HERRERA
Suffix:
Gender:M
Credentials:MD, FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 E ANTIETAM ST
Mailing Address - Street 2:SUITE 306B
Mailing Address - City:HAGERSTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:21740-5754
Mailing Address - Country:US
Mailing Address - Phone:301-739-7790
Mailing Address - Fax:301-739-4093
Practice Address - Street 1:324 E ANTIETAM ST STE 306B
Practice Address - Street 2:
Practice Address - City:HAGERSTOWN
Practice Address - State:MD
Practice Address - Zip Code:21740-5768
Practice Address - Country:US
Practice Address - Phone:301-739-7790
Practice Address - Fax:301-739-4093
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-15
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00384662086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD081ZMedicare PIN
MD737CMedicare PIN
MDE27521Medicare UPIN