DAVID M HERZOG MD PC; NPI #1033225370

Contact Information

DAVID M HERZOG MD PC

1855 RICHMOND AVE
STATEN ISLAND, NY 10314-3909

Phone: 347-745-2828
Fax: 718-761-7226
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Gynecologic Oncology	207VX0201X	16	Physician/Obstetrics & Gynecology

Indicates primary specialty

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NPI Profile & details for DAVID M HERZOG MD PC

NPI Number 1033225370

LBN Legal business name DAVID M HERZOG MD PC

Authorized official DAVID HERZOG - (OWNER PHYSICIAN)

Entity Organization

Organization subpart ¹ No

Enumeration date 08/21/2006

Last updated 08/22/2020 - About 6 years ago

Identifiers

NY	License #	172295-NY
NY	Medicaid	1195353

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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