Healthcare Provider Details

I. General information

NPI: 1508563594
Provider Name (Legal Business Name): HYMAN INTEGRATIVE THERAPIES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2023
Last Update Date: 02/10/2023
Certification Date: 02/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 PITTSFIELD ROAD SUITE 9
LENOX MA
01240
US

IV. Provider business mailing address

55 PITTSFIELD ROAD SUITE 9
LENOX MA
01240
US

V. Phone/Fax

Practice location:
  • Phone: 413-637-9991
  • Fax: 413-637-9995
Mailing address:
  • Phone: 413-637-9991
  • Fax: 413-637-9995

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: MARK HYMAN
Title or Position: FOUNDER & DIRECTOR
Credential: MD
Phone: 413-637-9991