Provider Demographics
NPI:1780682120
Name:HYMAN, SEAN D
Entity Type:Individual
Prefix:
First Name:SEAN
Middle Name:D
Last Name:HYMAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 MORGANTOWN RD
Mailing Address - Street 2:
Mailing Address - City:READING
Mailing Address - State:PA
Mailing Address - Zip Code:19611-2059
Mailing Address - Country:US
Mailing Address - Phone:610-898-0888
Mailing Address - Fax:610-898-0891
Practice Address - Street 1:320 MORGANTOWN RD
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:PA
Practice Address - Zip Code:19611-2059
Practice Address - Country:US
Practice Address - Phone:610-898-0888
Practice Address - Fax:610-898-0891
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-11
Last Update Date:2015-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG000031152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA3000327OtherKEYSTONE CENTRAL
PA5912273OtherAETNA
PAEL1655020OtherHIGHMARK BLUE SHIELD
PA50041624OtherCAPITAL BLUE CROSS
5279300001Medicare NSC
PA5912273OtherAETNA
U62972Medicare UPIN