DAVID M HERZOG MD PC (NPI# 1033225370) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033225370 |
| Entity Type | Organization |
| Organization Name | DAVID M HERZOG MD PC |
| Practice Address |
1855 Richmond Ave Staten Island NY 10314-3909 |
| Practice Telephone | 3477452828 |
| Practice Fax Number | 7187617226 |
| Mailing Telephone | 3477452828 |
| Mailing Fax Number | 7187617226 |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2020-08-22 |
| Authorized Official Name | DAVID M HERZOG (OWNER PHYSICIAN) |
| Authorized Official Telephone | 3477452828 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VX0201X |
Obstetrics & Gynecology Specialization: Gynecologic Oncology |
172295-NY | NY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 1195353 | 05 |
| Street Address |
1855 RICHMOND AVE |
| City | STATEN ISLAND |
| State | NY |
| Zip Code | 10314-3909 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1285635565 | Tamara Sibalic-mandic | Internal Medicine | 1855 Richmond Ave, Suite 102, Staten Island, NY 10314-3940 | 2005-08-09 |
| 1538717079 | In Balance Physical Therapy, Pllc | Clinic/Center | 1855 Richmond Ave, Staten Island, NY 10314-3940 | 2019-08-28 |
| 1447732649 | Audiology Services Company Usa, LLC | Audiologist-Hearing Aid Fitter | 1855 Richmond Ave, Staten Island, NY 10314-3940 | 2018-09-04 |
| 1760700843 | Azalesha Abrahim Rodriguez | Physician Assistant | 1855 Richmond Ave, Staten Island, NY 10314-3940 | 2010-05-13 |
| 1477703130 | Michael Hamlen Campanella | Obstetrics & Gynecology | 1855 Richmond Ave, Staten Island, NY 10314 | 2008-09-30 |
| 1205876018 | Richard Rouder, Dpm, PC | Podiatrist | 1855 Richmond Ave, Staten Island, NY 10314-3912 | 2006-06-08 |
| 1174574651 | Gwenn Lentine | Obstetrics & Gynecology | 1855 Richmond Ave, Staten Island, NY 10314-3909 | 2006-05-12 |
| 1487618468 | David M Herzog | Obstetrics & Gynecology | 1855 Richmond Ave, Staten Island, NY 10314-3909 | 2006-04-14 |
| 1225098866 | Saam A Miller | Obstetrics & Gynecology | 1855 Richmond Ave, Staten Island, NY 10314-3909 | 2006-03-27 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568076255 | Edward Leccese | Massage Therapist | 77 Renee Place, Staten Island, NY 10314 | 2020-09-01 |
| 1871154633 | Matthew Richard Puliatti | Counselor | 1688 Victory Boulevard, Staten Island, NY 10314 | 2019-06-24 |
| 1750845137 | Miriam Gordon Pediatric Np PC | Nurse Practitioner | 7 Ismay Street, Staten Island, NY 10314 | 2019-01-30 |
| 1003391186 | 2791 Richmond LLC | Dentist | 2791 Richmond Avenue, Suite 2, Staten Island, NY 10314 | 2018-09-25 |
| 1477046522 | Miriam A Madry | Optometrist | 569 Woolley Ave, Staten Island, NY 10314 | 2018-06-13 |
| 1174025894 | Staten Island Dentistry P.C. | Clinic/Center | 979 Willowbrook Rd., Staten Island, NY 10314 | 2018-03-08 |
| 1205335023 | Ashley Larsen | Early Intervention Provider Agency | 229 Wellington Ct, Staten Island, NY 10314 | 2018-02-07 |
| 1306369699 | Victoria Ali | Behavior Technician | 228 Melvin Avenue, Staten Island, NY 10314 | 2017-07-19 |
| 1700307360 | Lydia Mora | Specialist | 2025 Richmond Avenue Suite 200, Staten Island, NY 10314 | 2017-07-03 |
| 1366971707 | Lisa Pietracatella | Massage Therapist | 92 Margaretta Court, Staten Island, NY 10314 | 2017-06-08 |
| Find all providers in zip 10314 | ||||
| Taxonomy Code | 207VX0201X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecologic Oncology |
| An obstetrician/gynecologist who provides consultation and comprehensive management of patients with gynecologic cancer, including those diagnostic and therapeutic procedures necessary for the total care of the patient with gynecologic cancer and resulting complications. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definiton added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Obstetrics and Gynecology, 2007. http://www.abog.org/. American Osteopathic Board of Obstetrics and Gynecology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Obstetrics and Gynecology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Obstetrics and Gynecology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073596300 | Mitchell Maiman | Obstetrics & Gynecology | 265 Mason Ave, Staten Island, NY 10305-3417 | 2005-11-21 |
| 1104995356 | Eli Serur | Obstetrics & Gynecology | 475 Seaview Ave, 2nd Floor- Ob/gyn, Staten Island, NY 10305-3436 | 2006-11-06 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295363125 | Health Quest Medical Practice, PC | Obstetrics & Gynecology | 1240 Ulster Ave--gyn. Onc. Dept., Kingston, NY 12401-1517 | 2020-03-27 |
| 1447803028 | Dib Sassine | Obstetrics & Gynecology | 1233 York Ave Apt 10q, New York, NY 10065-6342 | 2019-07-22 |
| 1578049417 | Derman Basaran | Obstetrics & Gynecology | 504 E 63rd St Apt 17l, New York, NY 10065-7920 | 2018-07-13 |
| 1740706415 | Benny Brandt | Obstetrics & Gynecology | 1233 York Ave Apt 11o, New York, NY 10065-6342 | 2017-08-15 |
| 1447666862 | Zeitoun Medical Pllc | Obstetrics & Gynecology | 139 E 23rd St Fl 2, New York, NY 10010-3788 | 2014-07-07 |
| 1912265315 | David Gal | Obstetrics & Gynecology | 515 E 79th St Apt 28a, New York, NY 10075-0781 | 2012-04-24 |
| 1184990384 | Deanna Gerber | Obstetrics & Gynecology | 22 Heritage Dr Apt B, New City, NY 10956-5350 | 2012-04-02 |
| 1497032106 | Eugenia Girda | Obstetrics & Gynecology | 1732 E 13th St, Brooklyn, NY 11229-1902 | 2011-11-08 |
| 1972895092 | Gregory Matthew Gressel | Obstetrics & Gynecology | 1695 Eastchester Rd Ste 600, Bronx, NY 10461 | 2011-05-08 |
| 1366760282 | Jovana Yanique Martin | Obstetrics & Gynecology | 319 S Manning Blvd Ste 301, Albany, NY 12208 | 2010-05-17 |
| Find all providers with the same taxonomy | ||||
| City | STATEN ISLAND |
| Zip Code | 10314 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.