Provider Demographics
NPI:1104094184
Name:GARY S HIRSHFIELD MD PC
Entity type:Organization
Organization Name:GARY S HIRSHFIELD MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:S
Authorized Official - Last Name:HIRSHFIELD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:718-460-1200
Mailing Address - Street 1:176 60 UNION TURNPIKE
Mailing Address - Street 2:STE 110
Mailing Address - City:FRESH MEADOWS
Mailing Address - State:NY
Mailing Address - Zip Code:11366
Mailing Address - Country:US
Mailing Address - Phone:718-460-1200
Mailing Address - Fax:718-461-2135
Practice Address - Street 1:17660 UNION TPKE
Practice Address - Street 2:STE 110
Practice Address - City:FRESH MEADOWS
Practice Address - State:NY
Practice Address - Zip Code:11366-1526
Practice Address - Country:US
Practice Address - Phone:718-460-1200
Practice Address - Fax:718-461-2135
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-13
Last Update Date:2020-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY170510332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01172898Medicaid
NY1286100001Medicare NSC
NYE41143Medicare UPIN