Healthcare Provider Details

I. General information

NPI: 1164046868
Provider Name (Legal Business Name): ANNA HINGSTON HOPPER RRA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ANNA HINGSTON

II. Dates (important events)

Enumeration Date: 05/29/2020
Last Update Date: 05/09/2024
Certification Date: 05/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

71 PROSPECT AVE
HUDSON NY
12534-2907
US

IV. Provider business mailing address

6 WELLNESS WAY STE 201
LATHAM NY
12110-2156
US

V. Phone/Fax

Practice location:
  • Phone: 518-828-8224
  • Fax:
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code243U00000X
TaxonomyRadiology Practitioner Assistant
License Number000242
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: