Provider Demographics
NPI:1346008208
Name:HANSARD, YNEZ (LMT)
Entity Type:Individual
Prefix:
First Name:YNEZ
Middle Name:
Last Name:HANSARD
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:61 DOLL RD
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12721-5311
Mailing Address - Country:US
Mailing Address - Phone:347-675-1208
Mailing Address - Fax:
Practice Address - Street 1:580 ROUTE 303 STE 2
Practice Address - Street 2:
Practice Address - City:BLAUVELT
Practice Address - State:NY
Practice Address - Zip Code:10913-1105
Practice Address - Country:US
Practice Address - Phone:845-613-7185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-06
Last Update Date:2024-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY018569225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist