Healthcare Provider Details

I. General information

NPI: 1356427835
Provider Name (Legal Business Name): RITA F HURWITZ PH.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 BEDFORD ST SUITE 1
LEXINGTON MA
02420-4319
US

IV. Provider business mailing address

33 BEDFORD ST SUITE 1
LEXINGTON MA
02420-4319
US

V. Phone/Fax

Practice location:
  • Phone: 781-861-8828
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number3348
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: