Provider Demographics
NPI:1003821828
Name:HINSON, RAYMOND (M D)
Entity type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:
Last Name:HINSON
Suffix:
Gender:M
Credentials:M D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 EAST 210 STREET
Mailing Address - Street 2:MMC ANESTHESIOLOGY
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467
Mailing Address - Country:US
Mailing Address - Phone:718-920-4316
Mailing Address - Fax:718-881-2245
Practice Address - Street 1:111 EAST 210 STREET
Practice Address - Street 2:MMC ANESTHESIOLOGY
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467
Practice Address - Country:US
Practice Address - Phone:718-920-4316
Practice Address - Fax:718-881-2245
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2016-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY192199207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01690115Medicaid
NY01690115Medicaid
NY8H5041Medicare ID - Type Unspecified