Provider Demographics
NPI:1447304522
Name:HURWITZ, THOMAS J (EDD)
Entity type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:J
Last Name:HURWITZ
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 PROSPECT STREET
Mailing Address - Street 2:SUITE 1
Mailing Address - City:RIDGEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07450-4404
Mailing Address - Country:US
Mailing Address - Phone:201-447-2375
Mailing Address - Fax:201-784-0892
Practice Address - Street 1:1 PROSPECT STREET
Practice Address - Street 2:SUITE 1
Practice Address - City:RIDGEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07450-4404
Practice Address - Country:US
Practice Address - Phone:201-447-2375
Practice Address - Fax:201-784-0892
Is Sole Proprietor?:No
Enumeration Date:2007-01-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35S100117700103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
458959Medicare ID - Type Unspecified