Provider Demographics
NPI:1871561357
Name:HIRSH, LAURIE E (MD)
Entity type:Individual
Prefix:
First Name:LAURIE
Middle Name:E
Last Name:HIRSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1648 HUNTINGDON PIKE
Mailing Address - Street 2:1ST FLOOR BUSINESS OFFICE
Mailing Address - City:MEADOWBROOK
Mailing Address - State:PA
Mailing Address - Zip Code:19046-8001
Mailing Address - Country:US
Mailing Address - Phone:215-938-2040
Mailing Address - Fax:215-938-2042
Practice Address - Street 1:1650 HUNTINGDON PIKE
Practice Address - Street 2:SUITE 205
Practice Address - City:MEADOWBROOK
Practice Address - State:PA
Practice Address - Zip Code:19046-8004
Practice Address - Country:US
Practice Address - Phone:215-938-2940
Practice Address - Fax:215-938-2945
Is Sole Proprietor?:No
Enumeration Date:2006-03-09
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD419045207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1008152060002Medicaid
H93383Medicare UPIN
PA1008152060002Medicaid