Provider Demographics
NPI:1194842138
Name:HURVICH, MARVIN S (PHD)
Entity Type:Individual
Prefix:DR
First Name:MARVIN
Middle Name:S
Last Name:HURVICH
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400W END AVE 14A
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-5778
Mailing Address - Country:US
Mailing Address - Phone:212-243-2690
Mailing Address - Fax:
Practice Address - Street 1:401W END AVE 1E
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-5724
Practice Address - Country:US
Practice Address - Phone:212-243-2690
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-23
Last Update Date:2015-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68002943103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV7A821Medicare ID - Type Unspecified