Healthcare Provider Details

I. General information

NPI: 1265666796
Provider Name (Legal Business Name): TEMIMA HURVITZ M.A. CCC/SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/12/2009
Last Update Date: 05/12/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7014 141ST ST
FLUSHING NY
11367-1931
US

IV. Provider business mailing address

13644 72ND AVE
FLUSHING NY
11367-2328
US

V. Phone/Fax

Practice location:
  • Phone: 718-851-3300
  • Fax:
Mailing address:
  • Phone: 718-268-7283
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number007551-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: