Provider Demographics
NPI:1538048772
Name:HERSKOWITZ, MINDY (RN)
Entity type:Individual
Prefix:MISS
First Name:MINDY
Middle Name:
Last Name:HERSKOWITZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:HERSKOWITZ
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RN
Mailing Address - Street 1:49 DERBY AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1709
Mailing Address - Country:US
Mailing Address - Phone:347-724-3750
Mailing Address - Fax:
Practice Address - Street 1:4802 10TH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11219-2916
Practice Address - Country:US
Practice Address - Phone:347-724-3750
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-01
Last Update Date:2025-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY852336163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency