MEDICARE: DR. MELVIN B HURT DPM

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	213E00000X	Podiatrist	N005136	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1275580664
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MELVIN B HURT DPM

Provider Business Mailing Address
First Line	:	50 S 24TH ST
Second Line	:
City	:	WYANDANCH
State	:	NY
Zip	:	11798-2922
Country	:	US
Telephone Number	:	631-255-7234
Fax Number	:	631-920-5911

Provider Business Practice Location Address
First Line	:	25 W 45TH ST
Second Line	:	SUITE 402
City	:	NEW YORK
State	:	NY
Zip	:	10036-4902
Country	:	US
Telephone Number	:	212-704-4310
Fax Number	:	212-704-4311

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

Provider Enumeration Date	:	05/30/2006
Last Update Date	:	03/24/2016

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