Provider Demographics
NPI:1013996784
Name:HYMAN, DAVID BRUCE (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BRUCE
Last Name:HYMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1554 NORTHERN BLVD
Mailing Address - Street 2:SUITE 204
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3006
Mailing Address - Country:US
Mailing Address - Phone:516-365-3996
Mailing Address - Fax:516-365-4597
Practice Address - Street 1:1554 NORTHERN BLVD
Practice Address - Street 2:SUITE 204
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-3006
Practice Address - Country:US
Practice Address - Phone:516-365-3996
Practice Address - Fax:516-365-4597
Is Sole Proprietor?:No
Enumeration Date:2006-01-11
Last Update Date:2016-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY155936207SG0202X, 207SG0201X, 207SG0203X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)
No207SG0202XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Biochemical Genetics
No207SG0203XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Molecular Genetics
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
01611781390OtherAMA MEDICAL IDENTIFICATIO
NY00808200Medicaid
NYA60459Medicare UPIN
NY10D321DHMedicare ID - Type UnspecifiedMEDICARE NUMBER (BC/BS)