Provider Demographics
NPI:1629331897
Name:HINMAN, JUDY MARIE
Entity Type:Individual
Prefix:
First Name:JUDY
Middle Name:MARIE
Last Name:HINMAN
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 1:17 WEST STREET
Mailing Address - Street 2:
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953
Mailing Address - Country:US
Mailing Address - Phone:518-483-0090
Mailing Address - Fax:518-483-4827
Practice Address - Street 1:17 WEST ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1117
Practice Address - Country:US
Practice Address - Phone:518-483-0090
Practice Address - Fax:518-483-4827
Is Sole Proprietor?:No
Enumeration Date:2012-06-21
Last Update Date:2012-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist