Healthcare Provider Details

I. General information

NPI: 1861595985
Provider Name (Legal Business Name): EKATERINA HURST M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EKATERINA HILL MD

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/08/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 ELM ST
MANCHESTER NH
03101-1349
US

IV. Provider business mailing address

401 CYPRESS ST
MANCHESTER NH
03103-3628
US

V. Phone/Fax

Practice location:
  • Phone: 603-668-4111
  • Fax: 603-628-7757
Mailing address:
  • Phone: 603-668-4111
  • Fax: 603-628-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number13429
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: