David M Herzog MD PC

Primary specialty

Gynecologic Oncology PhysicianTaxonomy code 207VX0201X

License

172295-NY Issued in NY

Legal business name

DAVID M HERZOG MD PC

Practice address

1855 Richmond Ave
Staten Island, NY 10314-3909

Phone

(347) 745-2828

Fax

(718) 761-7226

NPI assigned

Aug 21, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

David M Herzog, MD

Title

Owner Physician

Phone

(347) 745-2828

Specialties & licenses 1

Addresses

Other identifiers 1

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5949/brand/1/csg/1/fhir/r4

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Jill Marie Mattern

  • Addiction (Substance Use Disorder) Counselor
  • Ukiah, CA
  • NPI 1669514253
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1033225370",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143909",
            "telephone_number": "347-745-2828",
            "fax_number": "718-761-7226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 RICHMOND AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143909",
            "telephone_number": "347-745-2828",
            "fax_number": "718-761-7226"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DAVID M HERZOG MD PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-21",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HERZOG",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER PHYSICIAN",
        "authorized_official_telephone_number": "347-745-2828",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VX0201X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Obstetrics & Gynecology, Gynecologic Oncology",
            "state": "NY",
            "license": "172295-NY",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1195353",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Nonna Datiashvili, MD
• Monique Datnova, FNP
• Adrienne Datta, PA-C
• Joanna Quinn Dattilo, LCSW
• David Joseph Romano DPM PC
• David Pierre, Inc
• Oluwamutiwa Akinade David
• Victoria Davide
• Adi Davidov, MD
• Ronnie Davidson, M.S. ED.

• Gynecologic Oncology Physician in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Gynecologic Oncology Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.