Provider Demographics
NPI:1063547578
Name:HERSCHBERG, SEYMOUR NATHAN (MD)
Entity type:Individual
Prefix:DR
First Name:SEYMOUR
Middle Name:NATHAN
Last Name:HERSCHBERG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 WEST END AVE
Mailing Address - Street 2:8P
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-4819
Mailing Address - Country:US
Mailing Address - Phone:212-724-7360
Mailing Address - Fax:
Practice Address - Street 1:205 WEST END AVE
Practice Address - Street 2:8P
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-4819
Practice Address - Country:US
Practice Address - Phone:212-724-7360
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY092575-1207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine