Provider Demographics
NPI:1255703997
Name:HOVORKA, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HOVORKA
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22 MITCHELL AVE
Mailing Address - Street 2:
Mailing Address - City:BABYLON
Mailing Address - State:NY
Mailing Address - Zip Code:11702-4109
Mailing Address - Country:US
Mailing Address - Phone:516-356-1009
Mailing Address - Fax:
Practice Address - Street 1:22 MITCHELL AVE
Practice Address - Street 2:
Practice Address - City:BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11702-4109
Practice Address - Country:US
Practice Address - Phone:516-356-1009
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst