Provider Demographics
NPI:1457525495
Name:FIVE TOWNS OBSTETRICAL & GYNECOLOGICAL ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:FIVE TOWNS OBSTETRICAL & GYNECOLOGICAL ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALEX
Authorized Official - Middle Name:G
Authorized Official - Last Name:HIRSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:516-593-7500
Mailing Address - Street 1:1800 ROCKAWAY AVE
Mailing Address - Street 2:SUITE 211
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-1665
Mailing Address - Country:US
Mailing Address - Phone:516-593-7500
Mailing Address - Fax:516-593-7535
Practice Address - Street 1:1800 ROCKAWAY AVE
Practice Address - Street 2:SUITE 211
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-1665
Practice Address - Country:US
Practice Address - Phone:516-593-7500
Practice Address - Fax:516-593-7535
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-22
Last Update Date:2013-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY156493207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY202274OtherGHI
NY45D821OtherBCBS
NY0000C05489OtherHEALTHNET
NY160025322OtherRAILROAD MEDICARE
NY4225716OtherAETNA PPO
NY1308147OtherFIRST HEALTH
NY28677OtherAETNA HMO
NY624OtherVYTRA
NYP441540OtherOXFORD
NYP441540OtherOXFORD
NY0000C05489OtherHEALTHNET
NY1308147OtherFIRST HEALTH
NYWXQQTIMedicare UPIN