Provider Demographics
NPI:1063506574
Name:HARDY, CURTIS L (MD)
Entity Type:Individual
Prefix:
First Name:CURTIS
Middle Name:L
Last Name:HARDY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9419 60TH AVE
Mailing Address - Street 2:SUITE D1
Mailing Address - City:ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11373-5069
Mailing Address - Country:US
Mailing Address - Phone:718-592-5151
Mailing Address - Fax:718-592-9195
Practice Address - Street 1:9419 60TH AVE
Practice Address - Street 2:SUITE D1
Practice Address - City:ELMHURST
Practice Address - State:NY
Practice Address - Zip Code:11373-5069
Practice Address - Country:US
Practice Address - Phone:718-592-5151
Practice Address - Fax:718-592-9195
Is Sole Proprietor?:No
Enumeration Date:2006-10-02
Last Update Date:2022-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217592207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02108381Medicaid
NY01HCQROtherGHI MEDICARE
NY244E31OtherEMPIRE MEDICARE
NY02108381Medicaid
04572Medicare ID - Type Unspecified