Provider Demographics
NPI:1164569695
Name:HURLEY, BARBARA (MLDT-CLT)
Entity Type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:
Last Name:HURLEY
Suffix:
Gender:F
Credentials:MLDT-CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 ELLICOTT PL
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10301-2106
Mailing Address - Country:US
Mailing Address - Phone:718-757-9524
Mailing Address - Fax:
Practice Address - Street 1:34 ELLICOTT PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10301-2106
Practice Address - Country:US
Practice Address - Phone:718-757-9524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist