Basic Information
| Provider Information | |||||||||
| NPI: | 1164491171 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HURT | ||||||||
| FirstName: | KIKI | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2 CATHARINE STREET, P.O. BOX 550 | ||||||||
| Address2: | EAST MANHATTAN ANESTHESIA PARTNERS, LLC | ||||||||
| City: | POUGHKEEPSIE | ||||||||
| State: | NY | ||||||||
| PostalCode: | 12602 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8668688415 | ||||||||
| FaxNumber: | 8457902675 | ||||||||
| Practice Location | |||||||||
| Address1: | 310 E 14TH STREET | ||||||||
| Address2: | NY EYE & EAR INFIRMARY | ||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 10003 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2129794464 | ||||||||
| FaxNumber: | 7735834295 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/14/2006 | ||||||||
| LastUpdateDate: | 06/11/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 06/11/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207L00000X | 267815 | NY | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207L00000X | A96718 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | 207LC0200X | A96718 | CA | N | Allopathic & Osteopathic Physicians | Anesthesiology | Critical Care Medicine | 207R00000X | A96718 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207L00000X | 267815-1NY | NY | Y | Allopathic & Osteopathic Physicians | Anesthesiology |
ID Information
| ID | Type | State | Issuer | Description | 00A967180 | 05 | CA | MEDICAID |