Provider Demographics
NPI:1609015007
Name:HURD, CHARLES F (RPH)
Entity Type:Individual
Prefix:
First Name:CHARLES
Middle Name:F
Last Name:HURD
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 AVENUE OF THE AMERICAS
Mailing Address - Street 2:APT 6B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-2024
Mailing Address - Country:US
Mailing Address - Phone:212-620-4202
Mailing Address - Fax:212-675-5416
Practice Address - Street 1:575 AVENUE OF THE AMERICAS
Practice Address - Street 2:APT 6B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2024
Practice Address - Country:US
Practice Address - Phone:212-620-4202
Practice Address - Fax:212-675-5416
Is Sole Proprietor?:No
Enumeration Date:2009-02-10
Last Update Date:2024-03-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY30194183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist