Provider Demographics
NPI:1750646915
Name:HRYMACK, KYLE N (OD)
Entity Type:Individual
Prefix:
First Name:KYLE
Middle Name:N
Last Name:HRYMACK
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:319 MADISON CT
Mailing Address - Street 2:
Mailing Address - City:BRICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08724-1628
Mailing Address - Country:US
Mailing Address - Phone:732-598-5763
Mailing Address - Fax:
Practice Address - Street 1:4-14 SADDLE RIVER RD
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-5632
Practice Address - Country:US
Practice Address - Phone:201-797-2747
Practice Address - Fax:201-797-5809
Is Sole Proprietor?:No
Enumeration Date:2012-07-12
Last Update Date:2013-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ27OA00639100152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist