Provider Demographics
NPI:1255151635
Name:HYMAN, LIORA SARAH (MT-BC)
Entity type:Individual
Prefix:
First Name:LIORA
Middle Name:SARAH
Last Name:HYMAN
Suffix:
Gender:X
Credentials:MT-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:489 WESTERN AVE APT 1
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12203-1512
Mailing Address - Country:US
Mailing Address - Phone:631-807-2983
Mailing Address - Fax:
Practice Address - Street 1:71 FULLER RD
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12205-5734
Practice Address - Country:US
Practice Address - Phone:518-641-1971
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY19143225A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225A00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMusic TherapistGroup - Single Specialty