Healthcare Provider Details

I. General information

NPI: 1518918663
Provider Name (Legal Business Name): VIRGINIA K HURLEY NP
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 AMBULANCE DRIVE
CLIFTON SPRINGS NY
14432
US

IV. Provider business mailing address

6 AMBULANCE DRIVE
CLIFTON SPRINGS NY
14432
US

V. Phone/Fax

Practice location:
  • Phone: 315-462-1472
  • Fax: 315-462-2639
Mailing address:
  • Phone: 315-462-1472
  • Fax: 315-462-2639

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberF4301201
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: