Provider Demographics
NPI:1801931191
Name:PENSTEIN-HIRT, RIVKIE
Entity type:Individual
Prefix:DR
First Name:RIVKIE
Middle Name:
Last Name:PENSTEIN-HIRT
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 1:1157 BROADWAY
Mailing Address - Street 2:SUITE 3
Mailing Address - City:HEWLETT
Mailing Address - State:NY
Mailing Address - Zip Code:11557-2325
Mailing Address - Country:US
Mailing Address - Phone:516-569-9100
Mailing Address - Fax:516-569-9200
Practice Address - Street 1:1157 BROADWAY
Practice Address - Street 2:SUITE 3
Practice Address - City:HEWLETT
Practice Address - State:NY
Practice Address - Zip Code:11557-2325
Practice Address - Country:US
Practice Address - Phone:516-569-9100
Practice Address - Fax:516-569-9200
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY199142207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01846304Medicaid