Provider Demographics
NPI:1962623421
Name:HERSH, DANIEL S (DC)
Entity type:Individual
Prefix:MISS
First Name:DANIEL
Middle Name:S
Last Name:HERSH
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 HUNGERFORD STREET
Mailing Address - Street 2:
Mailing Address - City:HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06106
Mailing Address - Country:US
Mailing Address - Phone:860-524-8955
Mailing Address - Fax:860-524-8636
Practice Address - Street 1:105 HUNGERFORD STREET
Practice Address - Street 2:
Practice Address - City:HARTFORD
Practice Address - State:CT
Practice Address - Zip Code:06106
Practice Address - Country:US
Practice Address - Phone:860-524-8955
Practice Address - Fax:860-524-8636
Is Sole Proprietor?:No
Enumeration Date:2007-05-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT000243111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT000243OtherLICENSE NUMBER
CT000243OtherLICENSE NUMBER
CT35000910Medicare ID - Type Unspecified