Basic Information
| Provider Information | |||||||||
| NPI: | 1528053915 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIRSCH | ||||||||
| FirstName: | ADAM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | DO | ||||||||
| OtherOrganizationName: | |||||||||
| OtherOrganizationType: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 400 E MAIN ST | ||||||||
| Address2: | NORTHERN WESTCHESTER HOSPITAL-MEDICAL AFFAIRS OFFICE | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105493417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146661680 | ||||||||
| FaxNumber: | 9146661965 | ||||||||
| Practice Location | |||||||||
| Address1: | 400 E MAIN ST | ||||||||
| Address2: | NORTHERN WESTCHESTER HOSPITAL | ||||||||
| City: | MOUNT KISCO | ||||||||
| State: | NY | ||||||||
| PostalCode: | 105493417 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9146661680 | ||||||||
| FaxNumber: | 9146661965 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/13/2005 | ||||||||
| LastUpdateDate: | 01/30/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
| AuthorizedOfficialLastName: | |||||||||
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| AuthorizedOfficialMiddleName: | |||||||||
| AuthorizedOfficialTitleorPosition: | |||||||||
| AuthorizedOfficialTelephone: | |||||||||
| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| AuthorizedOfficialNameSuffix: | |||||||||
| AuthorizedOfficialCredential: | |||||||||
| NPICertificationDate: | 01/30/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 232233 | NY | N | Allopathic & Osteopathic Physicians | Internal Medicine | 208M00000X | 232233 | NY | Y | Allopathic & Osteopathic Physicians | Hospitalist |
ID Information
| ID | Type | State | Issuer | Description | 2590213 | 01 | GHI PPO PROVIDER ID# | OTHER | 388169 | 01 | MVP PROVIDER ID | OTHER | 10110708-U104 | 01 | CDPHP PROVIDER & GRP ID # | OTHER | P3506906 | 01 | OXFORD HEALTH PROVIDER ID | OTHER | 3760623 | 01 | AETNA - HMO PROVIDER ID | OTHER | P00206151-DD0661 | 01 | RAILROAD MEDICARE PIN# | OTHER | 0000000087400 | 01 | GHI HMO PROVIDER ID # | OTHER | 033SE1 | 01 | EMPIRE BCBS PROVIDER ID | OTHER | 060422000008 | 01 | FIDELISCARE PROVIDER ID# | OTHER | 7223666 | 01 | AETNA-PPO PROVIDER ID | OTHER | 3C5202 | 01 | HEALTHNET-GRP PIN # | OTHER |