1225183577 NPI number — DR. HILLARY JILL PYKE O.D.

Table of content: DR. HILLARY JILL PYKE O.D. (NPI 1225183577)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225183577 NPI number — DR. HILLARY JILL PYKE O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
PYKE
Provider First Name:
HILLARY
Provider Middle Name:
JILL
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

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:
1225183577
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/21/2022
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 505
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
HOGANSBURG
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13655-0505
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
518-358-6075
Provider Business Mailing Address Fax Number:
518-358-6078

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
997 STATE RTE 37
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
HOGANSBURG
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
13655
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
518-358-6075
Provider Business Practice Location Address Fax Number:
518-358-6078
Provider Enumeration Date:
01/25/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  TUV006205-01 , 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: 820552036 . This is a "IRONWORKERS OF WESTERN NY" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 42093 . This is a "DAVIS VISION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 508 . This is a "DAVIS VISION CSEA" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 82-0552036 . This is a "PEQUOT PHARMACEUTICAL" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 146006 . This is a "EYEMED" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 82-0552036 . This is a "BLUE CROSS BLUE SHIELD" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 82-0552036 . This is a "SUPERIOR VISION" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 820552036 . This is a "MVP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 02385293 , issued by the state of ( NY ) . This identifiers is of the category "MEDICAID".
  • Identifier: 82-0552036 . This is a "VSP" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".
  • Identifier: 820552036 . This is a "RMSCO INS." identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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