Provider Demographics
NPI:1184864951
Name:HYNES, LISA DUCA (RN)
Entity type:Individual
Prefix:MRS
First Name:LISA
Middle Name:DUCA
Last Name:HYNES
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:LISA
Other - Middle Name:MICHELE
Other - Last Name:DUCA HYNES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:43 JOYCE LN
Mailing Address - Street 2:
Mailing Address - City:WOODBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11797-2124
Mailing Address - Country:US
Mailing Address - Phone:516-822-1696
Mailing Address - Fax:
Practice Address - Street 1:43 JOYCE LN
Practice Address - Street 2:
Practice Address - City:WOODBURY
Practice Address - State:NY
Practice Address - Zip Code:11797-2124
Practice Address - Country:US
Practice Address - Phone:516-822-1696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY349507163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse