Provider Demographics
NPI:1346203452
Name:HYMAN, RONNY HOWARD (DC)
Entity Type:Individual
Prefix:DR
First Name:RONNY
Middle Name:HOWARD
Last Name:HYMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:256 OLD NYACK TPKE
Mailing Address - Street 2:
Mailing Address - City:SPRING VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:10977-5741
Mailing Address - Country:US
Mailing Address - Phone:845-426-3701
Mailing Address - Fax:845-426-3702
Practice Address - Street 1:256 OLD NYACK TPKE
Practice Address - Street 2:
Practice Address - City:SPRING VALLEY
Practice Address - State:NY
Practice Address - Zip Code:10977-5741
Practice Address - Country:US
Practice Address - Phone:845-426-3701
Practice Address - Fax:845-426-3702
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX005960-1111N00000X
NJ38MC00430400111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U18090Medicare UPIN
NYX37291Medicare ID - Type Unspecified