Provider Demographics
NPI:1386690428
Name:GOLOVKINA-HYNES, ALLA YURIEVNA (MD)
Entity Type:Individual
Prefix:DR
First Name:ALLA
Middle Name:YURIEVNA
Last Name:GOLOVKINA-HYNES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ALLA
Other - Middle Name:YURIEVNA
Other - Last Name:GOLOVKINA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:158 FRONT ROYAL PIKE STE 303
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22602-4324
Mailing Address - Country:US
Mailing Address - Phone:540-409-5254
Mailing Address - Fax:540-409-5253
Practice Address - Street 1:158 FRONT ROYAL PIKE STE 303
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22602
Practice Address - Country:US
Practice Address - Phone:540-409-5254
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD034704207W00000X
VA0101235934207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VAP01040888OtherMEDICARE RAILROAD
VAVV1716AMedicare PIN
H90569Medicare UPIN