1306951272 NPI number — HYER PHYSICAL THERAPY PLLC

Table of content: (NPI 1306951272)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306951272 NPI number — HYER PHYSICAL THERAPY PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
HYER PHYSICAL THERAPY PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306951272
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/08/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 911
Provider Second Line Business Mailing Address:
6194 ROUTE 23A
Provider Business Mailing Address City Name:
TANNERVILLE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
12485-0911
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-589-6825
Provider Business Mailing Address Fax Number:
518-589-6826

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6194 ROUTE 23A
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
TANNERVILLE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
12485-0911
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-589-6825
Provider Business Practice Location Address Fax Number:
518-589-6826
Provider Enumeration Date:
08/20/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HYER
Authorized Official First Name:
ALISON
Authorized Official Middle Name:
M
Authorized Official Title or Position:
PHYSICAL THERAPIST OWNER
Authorized Official Telephone Number:
518-589-6825

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  0254871 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 383787 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 839606 . This is a "MPN" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: DE4605 . This is a "PALMETTO GBA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: Q23FB1 . This is a "EMPIRE BCBS" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 000408994001 . This is a "BSNENY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 0102406 . This is a "GHI PPO HMO" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: U925 . This is a "CDPHP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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