Provider Demographics
NPI:1407911241
Name:HINDS, JOHN (PHD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:
Last Name:HINDS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:35 HUDSON ST.
Mailing Address - Street 2:3A
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10701-6960
Mailing Address - Country:US
Mailing Address - Phone:914-410-4624
Mailing Address - Fax:
Practice Address - Street 1:35 HUDSON ST.
Practice Address - Street 2:3A
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10701-6960
Practice Address - Country:US
Practice Address - Phone:718-432-6543
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-22
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011794103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02644186Medicaid
NY0152DWMedicaid
NYV-8C371Medicare ID - Type UnspecifiedEMPIRE MEDICARE