Provider Demographics
NPI:1962181396
Name:HIRSCH, ANNIE
Entity type:Individual
Prefix:
First Name:ANNIE
Middle Name:
Last Name:HIRSCH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6 SLOANES BEACH RD
Mailing Address - Street 2:
Mailing Address - City:PORT WASHINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11050-1232
Mailing Address - Country:US
Mailing Address - Phone:516-361-0039
Mailing Address - Fax:
Practice Address - Street 1:6 SLOANES BEACH RD
Practice Address - Street 2:
Practice Address - City:PORT WASHINGTON
Practice Address - State:NY
Practice Address - Zip Code:11050-1232
Practice Address - Country:US
Practice Address - Phone:516-361-0039
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-13
Last Update Date:2023-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist