Provider Demographics
NPI:1467294165
Name:HYPACCESS
Entity type:Organization
Organization Name:HYPACCESS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO-FOUNDER AND CO-DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AUDRE
Authorized Official - Middle Name:
Authorized Official - Last Name:WIRTANEN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:775-343-2651
Mailing Address - Street 1:465 HARMAN ST APT 2L
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11237-4858
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:465 HARMAN ST APT 2L
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11237-4858
Practice Address - Country:US
Practice Address - Phone:775-343-2651
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-12
Last Update Date:2024-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QI0500XAmbulatory Health Care FacilitiesClinic/CenterInfusion TherapyGroup - Multi-Specialty