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NPI Code Detail

MEDICARE: MR. PATRICK JAMES HURLEY M.A.,NCSP

MEDICARE:  MR. PATRICK JAMES HURLEY  M.A.,NCSP
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
1103T00000XPsychologist2426OH

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1972760361
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. PATRICK JAMES HURLEY M.A.,NCSP
Provider Business Mailing Address
First Line : 3245 DUTCH RIDGE RD SE
Second Line :
City : NEW STRAITSVILLE
State : OH
Zip : 43766-9712
Country : US
Telephone Number : 740-342-4206
Fax Number :
Provider Business Practice Location Address
First Line : 3245 DUTCH RIDGE RD SE
Second Line :
City : NEW STRAITSVILLE
State : OH
Zip : 43766-9712
Country : US
Telephone Number : 740-342-4206
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/22/2008
Last Update Date : 05/22/2008

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