Provider Demographics
NPI:1801934120
Name:HYNDMAN, ANDREA DOLORES (MA TSHH)
Entity type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:DOLORES
Last Name:HYNDMAN
Suffix:
Gender:F
Credentials:MA TSHH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14 PINE PL
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-6319
Mailing Address - Country:US
Mailing Address - Phone:631-225-7755
Mailing Address - Fax:
Practice Address - Street 1:14 PINE PL
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-6319
Practice Address - Country:US
Practice Address - Phone:631-225-7755
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0083201235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist