Provider Demographics
NPI:1205099355
Name:HUREY, TINA (PT)
Entity type:Individual
Prefix:
First Name:TINA
Middle Name:
Last Name:HUREY
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SHILOH RD
Mailing Address - Street 2:
Mailing Address - City:LAUREL SPRINGS
Mailing Address - State:NJ
Mailing Address - Zip Code:08021-2733
Mailing Address - Country:US
Mailing Address - Phone:856-622-0105
Mailing Address - Fax:
Practice Address - Street 1:2716 ORTHODOX ST
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19137-1604
Practice Address - Country:US
Practice Address - Phone:215-743-4435
Practice Address - Fax:215-743-8848
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-09
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00368500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist