Provider Demographics
NPI:1184177859
Name:HERSH, SHAYNA
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:
Last Name:HERSH
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 1:320 CEDARHURST AVE
Mailing Address - Street 2:
Mailing Address - City:CEDARHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11516-1640
Mailing Address - Country:US
Mailing Address - Phone:917-371-0564
Mailing Address - Fax:
Practice Address - Street 1:320 CEDARHURST AVE
Practice Address - Street 2:
Practice Address - City:CEDARHURST
Practice Address - State:NY
Practice Address - Zip Code:11516-1640
Practice Address - Country:US
Practice Address - Phone:917-371-0564
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-29
Last Update Date:2016-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist