Provider Demographics
NPI:1568640092
Name:HYATT, ELIZABETH JOY (OD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:JOY
Last Name:HYATT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7621B WASHINGTON LN
Mailing Address - Street 2:
Mailing Address - City:ELKINS PARK
Mailing Address - State:PA
Mailing Address - Zip Code:19027-1036
Mailing Address - Country:US
Mailing Address - Phone:215-886-2412
Mailing Address - Fax:
Practice Address - Street 1:7621B WASHINGTON LN
Practice Address - Street 2:
Practice Address - City:ELKINS PARK
Practice Address - State:PA
Practice Address - Zip Code:19027-1036
Practice Address - Country:US
Practice Address - Phone:215-884-6267
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-02-06
Last Update Date:2022-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007219-1152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist