Provider Demographics
NPI:1447505680
Name:HYMAN, SIDNA A (LPN)
Entity type:Individual
Prefix:MS
First Name:SIDNA
Middle Name:A
Last Name:HYMAN
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:HYMAN
Other - Middle Name:AGATHA
Other - Last Name:HYMAN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LPN
Mailing Address - Street 1:21801 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD GARDENS
Mailing Address - State:NY
Mailing Address - Zip Code:11413-2205
Mailing Address - Country:US
Mailing Address - Phone:718-208-2991
Mailing Address - Fax:
Practice Address - Street 1:21801 136TH AVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11413-2205
Practice Address - Country:US
Practice Address - Phone:718-208-2991
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY308872-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse