Provider Demographics
NPI:1285442160
Name:SYNERGENOMICS, LLC
Entity type:Organization
Organization Name:SYNERGENOMICS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF OPERATIONS
Authorized Official - Prefix:
Authorized Official - First Name:KRISTIE
Authorized Official - Middle Name:
Authorized Official - Last Name:HYNNIMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:972-560-0346
Mailing Address - Street 1:30 LAFAYETTE AVE STE 1
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07960-4178
Mailing Address - Country:US
Mailing Address - Phone:972-560-0346
Mailing Address - Fax:
Practice Address - Street 1:30 LAFAYETTE AVE STE 1
Practice Address - Street 2:
Practice Address - City:MORRISTOWN
Practice Address - State:NJ
Practice Address - Zip Code:07960-4178
Practice Address - Country:US
Practice Address - Phone:972-560-0346
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-23
Last Update Date:2024-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Single Specialty