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NPI Code Detail

MEDICARE: JOSEPH HURTADO

MEDICARE:   JOSEPH  HURTADO
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant0173801NY

General Provider Information

NPI Number : 1699183574
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOSEPH HURTADO
Provider Business Mailing Address
First Line : 3612 E TREMONT AVE
Second Line :
City : BRONX
State : NY
Zip : 10465-2039
Country : US
Telephone Number : 718-409-9494
Fax Number :
Provider Business Practice Location Address
First Line : 3612 E TREMONT AVE
Second Line :
City : BRONX
State : NY
Zip : 10465-2039
Country : US
Telephone Number : 718-409-9494
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/23/2014
Last Update Date : 07/23/2014

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Directions to “ JOSEPH HURTADO ” Practice Location

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