Provider Demographics
NPI:1316067093
Name:HINCHMAN, GEORGIA LEE (NP)
Entity type:Individual
Prefix:MS
First Name:GEORGIA
Middle Name:LEE
Last Name:HINCHMAN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:22 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BLUE POINT
Mailing Address - State:NY
Mailing Address - Zip Code:11715-1307
Mailing Address - Country:US
Mailing Address - Phone:631-363-7070
Mailing Address - Fax:
Practice Address - Street 1:48 ROUTE 25A
Practice Address - Street 2:SUITE 301
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-1431
Practice Address - Country:US
Practice Address - Phone:631-862-3770
Practice Address - Fax:631-862-3835
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2008-11-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY360399363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health