Basic Information
| Provider Information | |||||||||
| NPI: | 1770781924 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HOSKIN | ||||||||
| FirstName: | TYRON | ||||||||
| MiddleName: | BERNARD | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | SR. | ||||||||
| Credential: | CASAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 11 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140862100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166814957 | ||||||||
| FaxNumber: | 7166814959 | ||||||||
| Practice Location | |||||||||
| Address1: | 11 W MAIN ST | ||||||||
| Address2: | |||||||||
| City: | LANCASTER | ||||||||
| State: | NY | ||||||||
| PostalCode: | 140862100 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7166814957 | ||||||||
| FaxNumber: | 7166814959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 07/10/2007 | ||||||||
| LastUpdateDate: | 07/12/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 101YA0400X | 11597 | NY | Y | Behavioral Health & Social Service Providers | Counselor | Addiction (Substance Use Disorder) |
No ID Information.