| Jared Hertz DO PC | |
|
700 Old Country Rd Ste 205 Plainview NY 11803-4932 | |
| (631) 271-9151 | |
| Not Available |
| Full Name | Jared Hertz DO PC |
|---|---|
| Speciality | Internal Medicine |
| Location | 700 Old Country Rd Ste 205, Plainview, New York |
| Authorized Official Name and Position | Jared Hertz (OWNER) |
| Authorized Official Contact | 6312719151 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Jared Hertz DO PC 700 Old Country Rd Ste 205 Plainview NY 11803-4932 Ph: (631) 271-9151 | Jared Hertz DO PC 700 Old Country Rd Ste 205 Plainview NY 11803-4932 Ph: (631) 271-9151 |
| NPI Number | 1881393452 |
|---|---|
| Provider Enumeration Date | 03/02/2023 |
| Last Update Date | 03/02/2023 |
| Certification Date | 03/02/2023 |
| Medicare PECOS PAC ID | 7810331436 |
|---|---|
| Medicare Enrollment ID | O20240221003929 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1881393452 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | () | Primary |
| Provider Name | Jared a Hertz |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1164782108 PECOS PAC ID: 0244481893 Enrollment ID: I20121108000315 |
| Provider Name | Philip Degaetano |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1174810436 PECOS PAC ID: 8224255310 Enrollment ID: I20160303001227 |
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