Healthcare Provider Details

I. General information

NPI: 1942396320
Provider Name (Legal Business Name): JONATHAN HURWIT LMSW
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/05/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

113 HOLLAND AVE
ALBANY NY
12208-3410
US

IV. Provider business mailing address

3278 MARILYN ST
SCHENECTADY NY
12303-4714
US

V. Phone/Fax

Practice location:
  • Phone: 518-626-5491
  • Fax:
Mailing address:
  • Phone: 518-355-7459
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number022835-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: