Provider Demographics
NPI:1336461854
Name:HERSHMAN, GEORGE GABRIEL (R,PH)
Entity Type:Individual
Prefix:MR
First Name:GEORGE
Middle Name:GABRIEL
Last Name:HERSHMAN
Suffix:
Gender:M
Credentials:R,PH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1041
Mailing Address - Street 2:
Mailing Address - City:REMSENBURG
Mailing Address - State:NY
Mailing Address - Zip Code:11960-1041
Mailing Address - Country:US
Mailing Address - Phone:631-801-2230
Mailing Address - Fax:
Practice Address - Street 1:38 PANTIGO RD
Practice Address - Street 2:
Practice Address - City:EAST HAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11937-2604
Practice Address - Country:US
Practice Address - Phone:631-324-8587
Practice Address - Fax:631-324-2720
Is Sole Proprietor?:No
Enumeration Date:2010-02-25
Last Update Date:2021-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY037764183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist