Provider Demographics
NPI:1699730119
Name:HERZ, ELIZABETH RODNEY (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:RODNEY
Last Name:HERZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:JEAN
Other - Last Name:RODNEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:435 HIGHLAND AVE., #110
Mailing Address - Street 2:
Mailing Address - City:CHESHIRE
Mailing Address - State:CT
Mailing Address - Zip Code:06410-3145
Mailing Address - Country:US
Mailing Address - Phone:203-272-0396
Mailing Address - Fax:203-272-0052
Practice Address - Street 1:435 HIGHLAND AVE.,
Practice Address - Street 2:#110
Practice Address - City:CHESHIRE
Practice Address - State:CT
Practice Address - Zip Code:06410-3145
Practice Address - Country:US
Practice Address - Phone:203-272-0396
Practice Address - Fax:203-272-0052
Is Sole Proprietor?:No
Enumeration Date:2006-04-18
Last Update Date:2014-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT035654208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics