Healthcare Provider Details

I. General information

NPI: 1154776565
Provider Name (Legal Business Name): KAREN HURWITZ
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/04/2016
Last Update Date: 05/04/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 CITY HALL MALL
MEDFORD MA
02155-4770
US

IV. Provider business mailing address

1 CITY HALL MALL
MEDFORD MA
02155-4770
US

V. Phone/Fax

Practice location:
  • Phone: 781-395-0023
  • Fax: 781-395-0025
Mailing address:
  • Phone: 781-395-0023
  • Fax: 781-395-0025

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code253Z00000X
TaxonomyIn Home Supportive Care Agency
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: