Provider Demographics
NPI:1851041214
Name:HURSH, LIANNA
Entity Type:Individual
Prefix:
First Name:LIANNA
Middle Name:
Last Name:HURSH
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 1:145 BORINQUEN PL APT 18
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-4631
Mailing Address - Country:US
Mailing Address - Phone:203-984-3938
Mailing Address - Fax:
Practice Address - Street 1:557 PENNSYLVANIA AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-5727
Practice Address - Country:US
Practice Address - Phone:203-984-3938
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-28
Last Update Date:2022-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program