Provider Demographics
NPI:1083802656
Name:TREVIA HAYDEN, MD LLC.
Entity Type:Organization
Organization Name:TREVIA HAYDEN, MD LLC.
Other - Org Name:VITALITY HEALTH ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:TREVIA
Authorized Official - Middle Name:FINESE
Authorized Official - Last Name:HAYDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-846-0434
Mailing Address - Street 1:97 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE 102
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4379
Mailing Address - Country:US
Mailing Address - Phone:301-846-0434
Mailing Address - Fax:301-846-0143
Practice Address - Street 1:97 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE 102
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4379
Practice Address - Country:US
Practice Address - Phone:301-846-0434
Practice Address - Fax:301-846-0143
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-09
Last Update Date:2008-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00530962084F0202X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084F0202XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyForensic PsychiatryGroup - Single Specialty
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD529P054HMedicare PIN