Provider Demographics
NPI:1225450778
Name:HEIN, TINA MARIE (RN)
Entity Type:Individual
Prefix:
First Name:TINA MARIE
Middle Name:
Last Name:HEIN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:TINA MARIE
Other - Middle Name:
Other - Last Name:HOROWITZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:62 CLEARWATER RD
Mailing Address - Street 2:PO BX 318
Mailing Address - City:HIGHLAND
Mailing Address - State:NY
Mailing Address - Zip Code:12528-1110
Mailing Address - Country:US
Mailing Address - Phone:845-522-9538
Mailing Address - Fax:
Practice Address - Street 1:62 CLEARWATER RD
Practice Address - Street 2:PO BX 318
Practice Address - City:HIGHLAND
Practice Address - State:NY
Practice Address - Zip Code:12528-1110
Practice Address - Country:US
Practice Address - Phone:845-522-9538
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-16
Last Update Date:2021-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY674486-1163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse