Provider Demographics
NPI:1750347654
Name:HERSHON, STUART J (MD)
Entity type:Individual
Prefix:DR
First Name:STUART
Middle Name:J
Last Name:HERSHON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1999 MARCUS AVENUE
Mailing Address - Street 2:SUITE 306
Mailing Address - City:LAKE SUCCESS
Mailing Address - State:NY
Mailing Address - Zip Code:11042-2900
Mailing Address - Country:US
Mailing Address - Phone:516-467-8600
Mailing Address - Fax:646-754-9820
Practice Address - Street 1:1999 MARCUS AVE
Practice Address - Street 2:SUITE 306
Practice Address - City:NEW HYDE PARK
Practice Address - State:NY
Practice Address - Zip Code:11042-1033
Practice Address - Country:US
Practice Address - Phone:516-467-8600
Practice Address - Fax:646-754-9820
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2021-04-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY092576174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY9691682008OtherCIGNA PPO
NY742043OtherAETNA
NYNS1716OtherOXFORD
NY3C8130OtherHEALTH NET
NYNS1716OtherOXFORD
NYB17369Medicare UPIN