Provider Demographics
NPI:1114073582
Name:HOYT, JAN-LAURITZEN (NP)
Entity Type:Individual
Prefix:
First Name:JAN-LAURITZEN
Middle Name:
Last Name:HOYT
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 MARYS AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:KINGSTON
Mailing Address - State:NY
Mailing Address - Zip Code:12401-5849
Mailing Address - Country:US
Mailing Address - Phone:845-338-0050
Mailing Address - Fax:845-331-1996
Practice Address - Street 1:117 MARYS AVE STE 101
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NY
Practice Address - Zip Code:12401-5849
Practice Address - Country:US
Practice Address - Phone:845-338-0050
Practice Address - Fax:845-331-1996
Is Sole Proprietor?:No
Enumeration Date:2007-01-26
Last Update Date:2019-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF300694363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner