Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225X00000X | Occupational Therapist | 03365 | MD |
NPI | 1003801614 |
---|---|
Provider Name | Mrs. Chana G. Hurvitz |
First Address | Baltimore, MD 21209-3944 |
Second Address | Baltimore, MD 21209-3944 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
372B | CAREFIRST BC/BS MD PROVID (01) | MD |
K1590001 | NATIONAL CAREFIRST PROVID (01) | MD |