Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 228354-1 | NY |
Y | 207RC0000X | Internist - Cardiovascular Disease | 228354 | NY |
NPI | 1326116575 |
---|---|
Provider Name | Dr. Jamie William Hynd |
First Address | Ogdensburg, NY 13669 |
Second Address | Ogdensburg, NY 13669 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/12/2006 |
Last Update Date | 19/06/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
02391380 | (05) | NY |
DD3379 | (02) | NY |
H74249 | (02) | NY |