Provider Demographics
NPI:1699771683
Name:HIRSHORN, STEVEN ALMOUR (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
Middle Name:ALMOUR
Last Name:HIRSHORN
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 1:2660 MAIN ST
Mailing Address - Street 2:STE 302
Mailing Address - City:BRIDGEPORT
Mailing Address - State:CT
Mailing Address - Zip Code:06606-5301
Mailing Address - Country:US
Mailing Address - Phone:203-331-8700
Mailing Address - Fax:203-335-5819
Practice Address - Street 1:2660 MAIN ST
Practice Address - Street 2:STE 302
Practice Address - City:BRIDGEPORT
Practice Address - State:CT
Practice Address - Zip Code:06606-5301
Practice Address - Country:US
Practice Address - Phone:203-331-8700
Practice Address - Fax:203-335-5819
Is Sole Proprietor?:No
Enumeration Date:2005-06-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT024621208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT001246214Medicaid
CT001246214Medicaid
CTB83286Medicare UPIN