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| Type | Person | [sources] | |||
|---|---|---|---|---|---|
| Name | CHARLES HERTZDOG · CHARLES HERTZOG · HERTZOG CHARLES F | [sources] | |||
| Birth date | [sources] | ||||
| Nationality | not available | [sources] | |||
| Country | United States of America | [sources] | |||
| First name | CHARLES | [sources] | |||
| ID Number | 00057679 | [sources] | |||
| Last name | HERTZDOG · HERTZOG | [sources] | |||
| NPI | 1124250543 | [sources] | |||
| Sector | Dentist | [sources] | |||
| Position | DENTIST (IND- LIC HC SERV PRO) | [sources] | |||
| Address | 354 WATERSIDE ROAD, NORTHPORT, NY 11768 · NORTHPORT, NY 11768, USA | [sources] | |||
| Last change | Last processed | First seen | |||
Medical providers deemed ineligible to participate in New York State's Medicaid program.
United States of America · OMIG
A database of suppliers who have been excluded from participating in US federal procurement.
United States of America · GSA
People and companies excluded from Federally funded health care programs
United States of America · OIG
us-medny-570d948c9b7b3a6faa63a4bd8c411a95f8c9b018 · us-fed-excl-charles-hertzdog-11768-northport · us-fed-excl-charles-hertzog-11768-northportFor experts: raw data explorer
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| United States of America | New York State Office of the Medicaid Inspector General | - | - |
| United States of America | Department of Health and Human Services Office of Inspector General | List of Excluded Individuals/Entities (LEIE) | - |
| United States of America | HHS | Reciprocal | - |