Provider Demographics
NPI:1649364092
Name:HOYT, RICHARD HERBERT (PHD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:HERBERT
Last Name:HOYT
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 CASTLE ST
Mailing Address - Street 2:
Mailing Address - City:GENEVA
Mailing Address - State:NY
Mailing Address - Zip Code:14456-1454
Mailing Address - Country:US
Mailing Address - Phone:315-576-1105
Mailing Address - Fax:
Practice Address - Street 1:665 CASTLE ST
Practice Address - Street 2:
Practice Address - City:GENEVA
Practice Address - State:NY
Practice Address - Zip Code:14456-1454
Practice Address - Country:US
Practice Address - Phone:315-576-1105
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-02
Last Update Date:2014-02-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY006492103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00801905Medicaid
NYP020006492OtherBLUE SHIELD
NYRA9130Medicare ID - Type Unspecified
NYIA0886Medicare ID - Type Unspecified