Provider Demographics
NPI:1841216371
Name:HURVITZ, MONICA DENISSE (MD)
Entity Type:Individual
Prefix:
First Name:MONICA
Middle Name:DENISSE
Last Name:HURVITZ
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 E 109TH ST APT 5B
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-3771
Mailing Address - Country:US
Mailing Address - Phone:318-572-6519
Mailing Address - Fax:
Practice Address - Street 1:333 E 109TH ST APT 5B
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-3771
Practice Address - Country:US
Practice Address - Phone:318-572-6519
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-15
Last Update Date:2016-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2486052085R0202X, 2085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology