Provider Demographics
NPI:1093078230
Name:DEHAYES, DIANNE
Entity Type:Individual
Prefix:MS
First Name:DIANNE
Middle Name:
Last Name:DEHAYES
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:22018 HORACE HARDING EXPY
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2227
Mailing Address - Country:US
Mailing Address - Phone:718-423-0056
Mailing Address - Fax:
Practice Address - Street 1:22018 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364-2227
Practice Address - Country:US
Practice Address - Phone:718-423-0056
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-22
Last Update Date:2012-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator