Provider Demographics
NPI:1053592931
Name:HURWITZ, BEVERLY (LIC AC)
Entity type:Individual
Prefix:
First Name:BEVERLY
Middle Name:
Last Name:HURWITZ
Suffix:
Gender:F
Credentials:LIC AC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 W 63RD ST
Mailing Address - Street 2:#12S
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10023-7103
Mailing Address - Country:US
Mailing Address - Phone:212-262-0027
Mailing Address - Fax:
Practice Address - Street 1:30 W 63RD ST
Practice Address - Street 2:#12S
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10023-7103
Practice Address - Country:US
Practice Address - Phone:212-262-0027
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-11-19
Last Update Date:2007-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist