Healthcare Provider Details

I. General information

NPI: 1053299032
Provider Name (Legal Business Name): HYERI HUR FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2025
Last Update Date: 08/26/2025
Certification Date: 08/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 BROADWAY RM 2403
NEW YORK NY
10018-0101
US

IV. Provider business mailing address

1441 BROADWAY RM 2403
NEW YORK NY
10018-0101
US

V. Phone/Fax

Practice location:
  • Phone: 212-201-1043
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF357073
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: