Provider Demographics
NPI:1982355053
Name:HERTZ, JOELLE ZOE (OTHER)
Entity Type:Individual
Prefix:MS
First Name:JOELLE
Middle Name:ZOE
Last Name:HERTZ
Suffix:
Gender:F
Credentials:OTHER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:240 CENTRE ST
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1806
Mailing Address - Country:US
Mailing Address - Phone:516-603-7164
Mailing Address - Fax:
Practice Address - Street 1:257 BEACH 17TH ST
Practice Address - Street 2:
Practice Address - City:FAR ROCKAWAY
Practice Address - State:NY
Practice Address - Zip Code:11691-4433
Practice Address - Country:US
Practice Address - Phone:718-868-2300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-01-11
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246Z00000XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, Other