Provider Demographics
NPI:1639184542
Name:HYLKEMA, INGRID JOHANNA SJOERDJE (PT)
Entity Type:Individual
Prefix:MS
First Name:INGRID
Middle Name:JOHANNA SJOERDJE
Last Name:HYLKEMA
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3752 ROUTE 9G
Mailing Address - Street 2:
Mailing Address - City:RHINEBECK
Mailing Address - State:NY
Mailing Address - Zip Code:12572-1173
Mailing Address - Country:US
Mailing Address - Phone:845-876-8220
Mailing Address - Fax:845-876-8221
Practice Address - Street 1:3752 ROUTE 9G
Practice Address - Street 2:
Practice Address - City:RHINEBECK
Practice Address - State:NY
Practice Address - Zip Code:12572-1173
Practice Address - Country:US
Practice Address - Phone:845-876-8220
Practice Address - Fax:845-876-8221
Is Sole Proprietor?:No
Enumeration Date:2006-07-29
Last Update Date:2007-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015972-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYP2791617OtherOXFORD PROVIDER ID
NY2042030OtherUNITED HELATHCARE PROV ID
NY810921OtherACN GROUP
NYQL6872OtherEMPIRE PROVIDER ID
NY1003832692OtherGROUP NPI#
NY9386156OtherPHCS PROVIDER ID
NY2984871OtherAETNA PROVIDER ID
NY437866OtherMVP PROVIDER ID
NY55419OtherGHI-HMO PROV ID
NYKI0Q0WSI10OtherMEDICARE GROUP # EMC
NYIH0QL68720OtherMEDICARE I.HYLKEMA EMC#
NYQL687Q0SI1OtherMEDICARE I.HYLKEMA PAPER#
NY2984871OtherAETNA PROVIDER ID
NYKI0Q0WSI10OtherMEDICARE GROUP # EMC