Individual
EMILY E HURSTAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH, MAS
Contact information
Practice address
801 MASSACHUSETTS AVE, CROSSTOWN 6C, BOSTON, MA 02118
(617) 414-5951
(617) 414-9201
Mailing address
960 MASSACHUSETTS AVE, FL2 PROVIDER ENROLLMENT, BOSTON, MA 02118
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
283902
MA
2083A0300X
Addiction Medicine (Preventive Medicine) Physician
283902
MA
Other
Enumeration date
04/21/2010
Last updated
04/04/2024
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