Provider Demographics
NPI:1790781227
Name:DYMES, SHARINE M (DC)
Entity Type:Individual
Prefix:DR
First Name:SHARINE
Middle Name:M
Last Name:DYMES
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 STATE ROUTE 7
Mailing Address - Street 2:STE 5
Mailing Address - City:COBLESKILL
Mailing Address - State:NY
Mailing Address - Zip Code:12043-5740
Mailing Address - Country:US
Mailing Address - Phone:518-234-4316
Mailing Address - Fax:518-234-4316
Practice Address - Street 1:2403 STATE ROUTE 7
Practice Address - Street 2:STE 5
Practice Address - City:COBLESKILL
Practice Address - State:NY
Practice Address - Zip Code:12043-5740
Practice Address - Country:US
Practice Address - Phone:518-234-4316
Practice Address - Fax:518-234-4316
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-06-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX007619111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX64621OtherBCBS #
NY5802966OtherGHI#
NY01207000OtherBCBS UTICA-WATERTOWN
NY10022105OtherCDPHP#
NYCO7619-2OtherWCB#
NY10022105OtherCDPHP#
NY01207000OtherBCBS UTICA-WATERTOWN