Healthcare Provider Details

I. General information

NPI: 1326466392
Provider Name (Legal Business Name): EVA HURWITZ OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/06/2014
Last Update Date: 04/06/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

205 STEVEN PL APT A1
WOODMERE NY
11598-2553
US

IV. Provider business mailing address

205 STEVEN PL APT A1
WOODMERE NY
11598-2553
US

V. Phone/Fax

Practice location:
  • Phone: 516-603-8642
  • Fax:
Mailing address:
  • Phone: 516-603-8642
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number018558
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: