Provider Demographics
NPI:1811985203
Name:HERSHKOWITZ, JON E (MD)
Entity type:Individual
Prefix:DR
First Name:JON
Middle Name:E
Last Name:HERSHKOWITZ
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 1:120 SUMMIT AVE
Mailing Address - Street 2:SUMMIT MEDICAL GROUP
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-2804
Mailing Address - Country:US
Mailing Address - Phone:908-273-4300
Mailing Address - Fax:908-790-6524
Practice Address - Street 1:120 SUMMIT AVE
Practice Address - Street 2:SUMMIT MEDICAL GROUP
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-2804
Practice Address - Country:US
Practice Address - Phone:908-277-8880
Practice Address - Fax:908-277-8779
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-10
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA69995207R00000X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Not Answered208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ034578BSDMedicare ID - Type UnspecifiedMEDICARE#
NJF84683Medicare UPIN