Healthcare Provider Details

I. General information

NPI: 1972086494
Provider Name (Legal Business Name): AMY N HURLEY
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 BOX POND ROAD
BELLINGHAM MA
02019-0201
US

IV. Provider business mailing address

36 BOX POND RD
BELLINGHAM MA
02019-1489
US

V. Phone/Fax

Practice location:
  • Phone: 617-916-5069
  • Fax:
Mailing address:
  • Phone: 617-916-5069
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: