Healthcare Provider Details

I. General information

NPI: 1811168867
Provider Name (Legal Business Name): DR. WILLIAM HURWITZ
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/18/2008
Last Update Date: 03/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

630 FIFTH AVENUE 1862
NEW YORK NY
10111
US

IV. Provider business mailing address

630 FIFTH AVENUE 1862
NEW YORK NY
10111
US

V. Phone/Fax

Practice location:
  • Phone: 212-246-3511
  • Fax: 212-757-6077
Mailing address:
  • Phone: 212-246-3511
  • Fax: 212-757-6077

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number026189
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: