Basic Information
Provider Information
NPI: 1356539407
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HURFORD
FirstName: IRENE
MiddleName: M.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: BRATTI
OtherFirstName: IRENE
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 3535 MARKET ST
Address2: 3RD FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191043309
CountryCode: US
TelephoneNumber: 2156622826
FaxNumber:  
Practice Location
Address1: 3535 MARKET ST
Address2: 3RD FLOOR
City: PHILADELPHIA
State: PA
PostalCode: 191043309
CountryCode: US
TelephoneNumber: 2156622826
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/12/2007
LastUpdateDate: 07/06/2015
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XMD435949PAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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