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Individual
MR. THEODORE L HERNITCHE JR.
Active
Individual
MR. THEODORE L HERNITCHE JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LCSW
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R038418-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7481499
GHI PIN #
NY
01
—
A347769
VALUEOPTIONS VENDOR ID
NY
01
—
N7X831
EMPIRE BC/BS PROVIDER ID
NY
01
—
P3385576
OXFORD PROVIDER #
NY
01
—
R038418-1
NEW YORK STATE LICENSE #
NY
Enumeration date
08/30/2006
Last updated
09/11/2017
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