Provider Demographics
NPI:1356339949
Name:HURWITZ, JUDY BETH (DPM)
Entity type:Individual
Prefix:DR
First Name:JUDY
Middle Name:BETH
Last Name:HURWITZ
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 CHARLES ST
Mailing Address - Street 2:#528
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02114-4604
Mailing Address - Country:US
Mailing Address - Phone:617-256-5839
Mailing Address - Fax:
Practice Address - Street 1:66 CHARLES ST
Practice Address - Street 2:#528
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-4604
Practice Address - Country:US
Practice Address - Phone:617-256-5839
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA2150213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAU80687Medicare UPIN
MAY75084Medicare ID - Type Unspecified