Provider Demographics
NPI:1699863720
Name:HIRSCH, HOWARD J (MD)
Entity type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:J
Last Name:HIRSCH
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 1:100 FALMOUTH STREET
Mailing Address - Street 2:
Mailing Address - City:SHORT HILLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07078-1504
Mailing Address - Country:US
Mailing Address - Phone:973-379-1597
Mailing Address - Fax:973-379-4440
Practice Address - Street 1:100 FALMOUTH STREET
Practice Address - Street 2:
Practice Address - City:SHORT HILLS
Practice Address - State:NJ
Practice Address - Zip Code:07078-1505
Practice Address - Country:US
Practice Address - Phone:973-379-1597
Practice Address - Fax:973-379-4440
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2015-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA052890002085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0743208Medicaid
NJE53510Medicare UPIN
NJE53510Medicare UPIN