Provider Demographics
NPI:1811077936
Name:HIRSCH, JOEL A (DDS,PC)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:A
Last Name:HIRSCH
Suffix:
Gender:M
Credentials:DDS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:570 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-7370
Mailing Address - Country:US
Mailing Address - Phone:212-758-5858
Mailing Address - Fax:212-308-0464
Practice Address - Street 1:570 PARK AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-7370
Practice Address - Country:US
Practice Address - Phone:212-758-5858
Practice Address - Fax:212-308-0464
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0301861223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics