Healthcare Provider Details

I. General information

NPI: 1396943239
Provider Name (Legal Business Name): HURLEY DERMATOLOGY,PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 06/14/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 PAOLI PIKE
WEST CHESTER PA
19380-4642
US

IV. Provider business mailing address

1101 PAOLI PIKE
WEST CHESTER PA
19380-4642
US

V. Phone/Fax

Practice location:
  • Phone: 610-918-4820
  • Fax: 610-918-4816
Mailing address:
  • Phone: 610-918-4820
  • Fax: 610-918-4816

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License NumberBH1650743
License Number StatePA

VIII. Authorized Official

Name: DR. JEFFREY P HURLEY
Title or Position: PRESIDENT
Credential: M.D.
Phone: 610-918-4820