Provider Demographics
NPI:1982027454
Name:HERSHKOP, KRENA
Entity Type:Individual
Prefix:MRS
First Name:KRENA
Middle Name:
Last Name:HERSHKOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:935 EASTERN PKWY
Mailing Address - Street 2:APT # 1-G
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11213-3662
Mailing Address - Country:US
Mailing Address - Phone:718-756-3279
Mailing Address - Fax:
Practice Address - Street 1:935 EASTERN PKWY
Practice Address - Street 2:APT # 1-G
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11213-3662
Practice Address - Country:US
Practice Address - Phone:718-756-3279
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-03
Last Update Date:2014-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3551380174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist