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NPI Code Detail

MEDICARE: DR. PABLO HURTADO LCSW

MEDICARE: DR. PABLO HURTADO LCSW
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
11041C0700XClinical Social Worker102490NY

General Provider Information

NPI Number : 1982331351
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PABLO HURTADO LCSW
Provider Business Mailing Address
First Line : 52 WOODSTREAM DR
Second Line :
City : GRAND ISLAND
State : NY
Zip : 14072-1485
Country : US
Telephone Number : 716-239-9311
Fax Number :
Provider Business Practice Location Address
First Line : 52 WOODSTREAM DR
Second Line :
City : GRAND ISLAND
State : NY
Zip : 14072-1485
Country : US
Telephone Number : 716-239-9311
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/04/2022
Last Update Date : 03/18/2026

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