Hertz, Jeffrey A

Hertz, Jeffrey A is an individual health care provider with primary practice located at 79 Wawecus St Ste 105, Norwich CT 06360. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Hertz, Jeffrey A can be contacted via phone (860) 886-0161.

Contact Information

Primary practice address
79 Wawecus St Ste 105 Norwich CT 06360
Phone: (860) 886-0161
Fax: (860) 889-5999
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 023601 Connecticut

Profile Details

NPI number 1881623486
LBN Legal business name Hertz, Jeffrey A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 3rd, 2006
Last updated Nov 12th, 2009 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1881623486 NPPES
Other 181413 PREFERRED ONE
Other 031460 PREFERRED ONE
Other NLS055 PREFERRED ONE
MEDICAID 001236017 PREFERRED ONE
Other 566780 PREFERRED ONE
Other 010023601CT01 PREFERRED ONE
Other 732141 PREFERRED ONE
Other 0804876 PREFERRED ONE
Other 0584458002 PREFERRED ONE

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