Doctor Name: | MRS. TAMARA HAYES |
NPI Number: | 1083890891 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | 012277 |
Business Practice Address: | 14 Technology Dr Suite 11 East Setauket, NY - 117333472 |
Business Phone Number: | 6314444233 |
Business Fax Number: | 6314444217 |
Mailing Address: | 14 Technology Dr, Suite 11 EAST SETAUKET |
State: | NY |
Postal Code: | 117333472 |
Phone Number: | 6314444233 |
Fax Number: | 6314444217 |
NPI Enumeration Date: | 01/11/2008 |
NPI Last Update Date: | 11/18/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 012277 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |