Provider Demographics
NPI:1811172596
Name:HURTADO, ALICIA MARLENE (MD)
Entity type:Individual
Prefix:DR
First Name:ALICIA
Middle Name:MARLENE
Last Name:HURTADO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1623 3RD AVE STE 201
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3638
Mailing Address - Country:US
Mailing Address - Phone:347-601-8484
Mailing Address - Fax:
Practice Address - Street 1:1623 3RD AVE STE 201
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-3638
Practice Address - Country:US
Practice Address - Phone:347-601-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-01
Last Update Date:2024-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2467272084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry