Individual provider Active NPI

Laurence J. Hirsch, MD

  • Endocrinology, Diabetes & Metabolism Physician
  • Wyckoff, NJ
National Provider Identifier
1558467068
Registry record updated May 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Endocrinology, Diabetes & Metabolism PhysicianTaxonomy code 207RE0101X
License
25MA05302100 Issued in NJ
Practice address
760 Frederick CT
Wyckoff, NJ 07481-1057
Phone
(201) 848-4884
NPI assigned
Sep 15, 2006
Last updated
May 20, 2020By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 20, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Endocrinology, Diabetes & Metabolism Physician 207RE0101X 25MA05302100 NJ Primary

Addresses

Primary practice location

760 Frederick CT
Wyckoff, NJ 07481-1057

Mailing address

760 Frederick CT
Wyckoff, NJ 07481-1057
Phone (201) 848-4884

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210519002952 NJ Order and Referring Only - EndocrinologyPractitioner - Endocrinology 5890194088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

NPI Registry JSON

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

{
    "created_epoch": "1158278400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589932800000",
    "number": "1558467068",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "760 FREDERICK CT",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811057",
            "telephone_number": "201-848-4884",
            "fax_number": "201-848-5117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "760 FREDERICK CT",
            "city": "WYCKOFF",
            "state": "NJ",
            "postal_code": "074811057",
            "telephone_number": "201-848-4884"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIRSCH",
        "first_name": "LAURENCE",
        "middle_name": "J.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-15",
        "last_updated": "2020-05-20",
        "certification_date": "2020-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RE0101X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Endocrinology, Diabetes & Metabolism",
            "state": "NJ",
            "license": "25MA05302100",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wyckoff, NJ

Sources for this page

Verify at the official NPI Registry.