Provider Demographics
NPI:1740380625
Name:GURR, HOWARD KEITH (PHD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:KEITH
Last Name:GURR
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 1:2 CORWIN CT
Mailing Address - Street 2:
Mailing Address - City:DIX HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11746-8314
Mailing Address - Country:US
Mailing Address - Phone:631-462-2467
Mailing Address - Fax:
Practice Address - Street 1:2 CORWIN CT
Practice Address - Street 2:
Practice Address - City:DIX HILLS
Practice Address - State:NY
Practice Address - Zip Code:11746-8314
Practice Address - Country:US
Practice Address - Phone:631-462-2467
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY007285103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYV18811Medicare ID - Type Unspecified
NYV18812Medicare ID - Type Unspecified