Provider Demographics
NPI:1164445938
Name:HAMILTON, JOY M (MD)
Entity Type:Individual
Prefix:
First Name:JOY
Middle Name:M
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:475 LENOX RD
Mailing Address - Street 2:#B
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11203-2019
Mailing Address - Country:US
Mailing Address - Phone:718-552-2273
Mailing Address - Fax:718-228-2896
Practice Address - Street 1:475 LENOX RD
Practice Address - Street 2:#B
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11203-2019
Practice Address - Country:US
Practice Address - Phone:718-552-2273
Practice Address - Fax:718-228-2896
Is Sole Proprietor?:No
Enumeration Date:2006-07-25
Last Update Date:2013-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA788472081P2900X, 208100000X
NY265078208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A788470Medicare PIN
CAH56374Medicare UPIN