Provider Demographics
NPI:1003801614
Name:HURVITZ, CHANA G (OT)
Entity type:Individual
Prefix:MRS
First Name:CHANA
Middle Name:G
Last Name:HURVITZ
Suffix:
Gender:F
Credentials:OT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6237 BERKELEY AVE
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21209-3944
Mailing Address - Country:US
Mailing Address - Phone:410-698-8804
Mailing Address - Fax:410-764-1493
Practice Address - Street 1:6237 BERKELEY AVE
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21209-3944
Practice Address - Country:US
Practice Address - Phone:410-698-8804
Practice Address - Fax:410-764-1493
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD03365225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDK1590001OtherNATIONAL CAREFIRST PROVID
MD372BOtherCAREFIRST BC/BS MD PROVID
MDK1590001OtherNATIONAL CAREFIRST PROVID
MD372BOtherCAREFIRST BC/BS MD PROVID