Basic Information
Provider Information | |||||||||
NPI: | 1093933509 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HINCHEY | ||||||||
FirstName: | SHERIFAT | ||||||||
MiddleName: | A | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | M.D. | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | OLAGESHIN | ||||||||
OtherFirstName: | SHERIFAT | ||||||||
OtherMiddleName: | ABIOLA | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | MD, MPH, FACP | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 20 EAST ST STE 20 | ||||||||
Address2: |   | ||||||||
City: | HANOVER | ||||||||
State: | MA | ||||||||
PostalCode: | 023391638 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 7815610460 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 81 HIGHLAND AVE | ||||||||
Address2: |   | ||||||||
City: | SALEM | ||||||||
State: | MA | ||||||||
PostalCode: | 019702714 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 9787411200 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 04/22/2007 | ||||||||
LastUpdateDate: | 02/08/2019 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | Y | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 10501 | ND | N |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 207R00000X | 258518 | MA | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   |
No ID Information.