MEDICARE: DR. MARVIN S. HURVICH PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103TC0700X	Clinical Psychologist	68002943	NY

General Provider Information

NPI Number	:	1194842138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARVIN S. HURVICH PH.D.

Provider Business Mailing Address
First Line	:	400W END AVE 14A
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5778
Country	:	US
Telephone Number	:	212-243-2690
Fax Number	:

Provider Business Practice Location Address
First Line	:	401W END AVE 1E
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10024-5724
Country	:	US
Telephone Number	:	212-243-2690
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/23/2007
Last Update Date	:	10/08/2015

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