Provider Demographics
NPI:1184864233
Name:HILLARY PYKE
Entity Type:Organization
Organization Name:HILLARY PYKE
Other - Org Name:MOHAWK VISION
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HILLARY
Authorized Official - Middle Name:JILL
Authorized Official - Last Name:PYKE
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:518-358-6075
Mailing Address - Street 1:PO BOX 505
Mailing Address - Street 2:
Mailing Address - City:HOGANSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:13655-0505
Mailing Address - Country:US
Mailing Address - Phone:518-358-6075
Mailing Address - Fax:518-358-6078
Practice Address - Street 1:997 STATE RTE 37
Practice Address - Street 2:
Practice Address - City:HOGANSBURG
Practice Address - State:NY
Practice Address - Zip Code:13655
Practice Address - Country:US
Practice Address - Phone:518-357-6075
Practice Address - Fax:518-358-6078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-03
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY6205152W00000X
NY7503156FX1800X
NY5043156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Multi-Specialty
No156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOpticianGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02385293Medicaid