Basic Information
| Provider Information | |||||||||
| NPI: | 1538278312 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HERSHENBAUM | ||||||||
| FirstName: | ESTHER | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | MRS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 1546 | ||||||||
| Address2: | |||||||||
| City: | ENGLEWOOD CLIFFS | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07632 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019456500 | ||||||||
| FaxNumber: | 2019451157 | ||||||||
| Practice Location | |||||||||
| Address1: | 663 PALISADE AVENUE | ||||||||
| Address2: | SUITE 101 | ||||||||
| City: | CLIFFSIDE PARK | ||||||||
| State: | NJ | ||||||||
| PostalCode: | 07010 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2019456500 | ||||||||
| FaxNumber: | 2019451157 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/29/2006 | ||||||||
| LastUpdateDate: | 06/30/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207N00000X | 25MA04552000 | NJ | Y | Allopathic & Osteopathic Physicians | Dermatology |
ID Information
| ID | Type | State | Issuer | Description | 02E121 | 01 | NJ | EMPIRE NY | OTHER | 0594202 | 05 | NJ | MEDICAID | 2123609 | 01 | NJ | US HEALTHCARE | OTHER |