Provider Demographics
NPI:1467438705
Name:HURWITZ, DIANA SUSAN
Entity Type:Individual
Prefix:MS
First Name:DIANA
Middle Name:SUSAN
Last Name:HURWITZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 DEARFIELD DR STE 106
Mailing Address - Street 2:
Mailing Address - City:GREENWICH
Mailing Address - State:CT
Mailing Address - Zip Code:06831-5351
Mailing Address - Country:US
Mailing Address - Phone:212-249-8884
Mailing Address - Fax:212-249-8884
Practice Address - Street 1:4 DEARFIELD DR
Practice Address - Street 2:
Practice Address - City:GREENWICH
Practice Address - State:CT
Practice Address - Zip Code:06831-5351
Practice Address - Country:US
Practice Address - Phone:212-249-8884
Practice Address - Fax:212-249-8884
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY020271207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0005000482OtherAETNA NON HMO
NY133884168OtherPOMCO
NY133884168OtherHORIZON HEALTHCARE OF NY
NY133884168OtherEMPIRE STATE PLAN (NYS)
NY220271OtherCONNECTICARE
NY2K8981/2K8982OtherBLUE CROSS PPO
NYP875670OtherOXFORD
NY0839247-010OtherCIGNA (SPEC) PPO ONLY
NY1427353OtherUNITED HEALTH CARE
NY070017752OtherRAILROAD MEDICARE
NY202271-3WOtherWORKERS COMPENSATION
NY2299480OtherGHO PPO
NY000000075724OtherGHI HMO
NY133884168OtherMULTIPLAN
NY3126642OtherAETNA HMO
NY133884168OtherHIP
NY133884168OtherPHCS
NY0839247-010OtherCIGNA (SPEC) PPO ONLY
NY133884168OtherHIP