1710150495 NPI number — MOSHE E HIRTH MD PA

Table of content: (NPI 1710150495)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1710150495 NPI number — MOSHE E HIRTH MD PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MOSHE E HIRTH MD PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1710150495
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/31/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6646 ATLANTIC AVE STE 100
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DELRAY BEACH
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
33446-1627
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
561-638-9533
Provider Business Mailing Address Fax Number:
561-638-7760

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6646 ATLANTIC AVE STE 100
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DELRAY BEACH
Provider Business Practice Location Address State Name:
FL
Provider Business Practice Location Address Postal Code:
33446-1627
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
561-638-9533
Provider Business Practice Location Address Fax Number:
561-638-7760
Provider Enumeration Date:
04/02/2008

Additional Information

Authorized Official

Authorized Official Last Name:
HIRTH
Authorized Official First Name:
MOSHE
Authorized Official Middle Name:
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
561-638-9533

Provider Taxonomy Codes

  • Taxonomy code: 207RG0100X , with the licence number:  ME64286 , registered in the state of FL ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 002083251 . This is a "APWU" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: M00000022576 . This is a "BLUE CROSS WESTERN NY" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 10659976120 . This is a "HUMANA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 29-70224 . This is a "UNITED HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 9983036 . This is a "UNIVERSAL HEALTHCARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 5897 . This is a "NEIGHBORHOOD HEALTH PARTNERSHIP" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 100012481 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 28447 . This is a "BLUE CROSS BLUE SHIELD OF FLA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2984313 . This is a "AARP - UHC" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 0005688748 . This is a "AETNA" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".
  • Identifier: 2499888 . This is a "GHI" identifier , issued by the state of ( FL ) . This identifiers is of the category "OTHER".




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