Provider Demographics
NPI:1528063229
Name:HERSHNER, TODD A (OD)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:A
Last Name:HERSHNER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9500 EUCLID AVE
Mailing Address - Street 2:CLEVELAND CLINIC
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44195
Mailing Address - Country:US
Mailing Address - Phone:440-988-4040
Mailing Address - Fax:440-988-4041
Practice Address - Street 1:5700 COOPER FOSTER PARK
Practice Address - Street 2:
Practice Address - City:LORAIN
Practice Address - State:OH
Practice Address - Zip Code:44053-2544
Practice Address - Country:US
Practice Address - Phone:440-988-4040
Practice Address - Fax:440-988-4041
Is Sole Proprietor?:No
Enumeration Date:2005-06-17
Last Update Date:2016-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH4020/T60152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH410022646OtherRAILROAD MEDICARE
OHF00273OtherAPEX
OH000000027221OtherANTHEM
OH0004381143OtherAETNA
OH0826931Medicaid
OH22-01355OtherUNITED HEALTHCARE
OH22-01355OtherUNITED HEALTHCARE
OH410022646OtherRAILROAD MEDICARE