MEDICARE: DR. MERLYN HURD PHD

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
1	103TC0700X	Clinical Psychologist	NY 7301	NY

General Provider Information

NPI Number	:	1851303648
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MERLYN HURD PHD

Provider Business Mailing Address
First Line	:	88 UNIVERSITY PL
Second Line	:	8TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10003-4513
Country	:	US
Telephone Number	:	212-807-8690
Fax Number	:	212-645-3076

Provider Business Practice Location Address
First Line	:	88 UNIVERSITY PL
Second Line	:	8TH FLOOR
City	:	NEW YORK
State	:	NY
Zip	:	10003-4513
Country	:	US
Telephone Number	:	212-807-8690
Fax Number	:	212-645-3076

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/12/2006
Last Update Date	:	07/08/2007

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