| Doctor Name: | DR. DAVID HAUERSTOCK |
| NPI Number: | 1063746964 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | 003694 |
| Business Practice Address: | 50 Leroy St Potsdam, NY - 136761786 |
| Business Phone Number: | 3152615890 |
| Business Fax Number: | |
| Mailing Address: | 172 River Rd, POTSDAM |
| State: | NY |
| Postal Code: | 136763101 |
| Phone Number: | 3152448775 |
| Fax Number: | |
| NPI Enumeration Date: | 09/24/2009 |
| NPI Last Update Date: | 06/06/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0203X |
| License Number: | 003694 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Therapeutic Radiology |
| Taxonomy Definition: | |