Healthcare Provider Details

I. General information

NPI: 1861508749
Provider Name (Legal Business Name): THOMAS FRANCIS HURLEY MSW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

718 SMYTH RD
MANCHESTER NH
03104-7004
US

IV. Provider business mailing address

112 W HAVEN RD
MANCHESTER NH
03104-2826
US

V. Phone/Fax

Practice location:
  • Phone: 603-624-4366
  • Fax:
Mailing address:
  • Phone: 603-668-1941
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberNONE
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: