Basic Information
Provider Information
NPI: 1003801614
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HURVITZ
FirstName: CHANA
MiddleName: G.
NamePrefix: MRS.
NameSuffix:  
Credential: O.T.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6237 BERKELEY AVE
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212093944
CountryCode: US
TelephoneNumber: 4106988804
FaxNumber: 4107641493
Practice Location
Address1: 6237 BERKELEY AVE
Address2:  
City: BALTIMORE
State: MD
PostalCode: 212093944
CountryCode: US
TelephoneNumber: 4106988804
FaxNumber: 4107641493
Other Information
ProviderEnumerationDate: 09/20/2005
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: X
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
225X00000X03365MDY Respiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist 

ID Information
IDTypeStateIssuerDescription
372B01MDCAREFIRST BC/BS MD PROVIDOTHER
K159000101MDNATIONAL CAREFIRST PROVIDOTHER


Home