Provider Demographics
NPI:1699867424
Name:HERSHKOWITZ-EPSTEIN, ALICIA G (OTR, CHT)
Entity type:Individual
Prefix:MS
First Name:ALICIA
Middle Name:G
Last Name:HERSHKOWITZ-EPSTEIN
Suffix:
Gender:F
Credentials:OTR, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 W MAIN ST
Mailing Address - Street 2:SUITE 109
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-3012
Mailing Address - Country:US
Mailing Address - Phone:631-893-1957
Mailing Address - Fax:631-893-1958
Practice Address - Street 1:475 NORTHERN BLVD STE 19
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4802
Practice Address - Country:US
Practice Address - Phone:516-829-0030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-29
Last Update Date:2023-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY003001-1225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ82731Medicare PIN
NY0877520002Medicare NSC