Provider Demographics
NPI:1508407511
Name:HYNES, EMILY
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:
Last Name:HYNES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1059 BEARTOWN RD
Mailing Address - Street 2:
Mailing Address - City:PAINTED POST
Mailing Address - State:NY
Mailing Address - Zip Code:14870-8552
Mailing Address - Country:US
Mailing Address - Phone:607-661-2362
Mailing Address - Fax:
Practice Address - Street 1:1059 BEARTOWN RD
Practice Address - Street 2:
Practice Address - City:PAINTED POST
Practice Address - State:NY
Practice Address - Zip Code:14870-8552
Practice Address - Country:US
Practice Address - Phone:607-661-2362
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-10-01
Last Update Date:2019-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program