Provider Demographics
NPI:1780230177
Name:HURLEY, KATHLEEN PATRICIA (PSYD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:PATRICIA
Last Name:HURLEY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 UNDERHILL BLVD STE 114
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-3436
Mailing Address - Country:US
Mailing Address - Phone:516-780-0111
Mailing Address - Fax:
Practice Address - Street 1:575 UNDERHILL BLVD STE 114
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-3436
Practice Address - Country:US
Practice Address - Phone:516-732-1644
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-08-13
Last Update Date:2019-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY023309103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist