Provider Demographics
NPI:1164874533
Name:SPENCER, HAYDEN JARED (MD)
Entity Type:Individual
Prefix:
First Name:HAYDEN
Middle Name:JARED
Last Name:SPENCER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 COMMUNITY DR
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-3876
Mailing Address - Country:US
Mailing Address - Phone:516-562-0100
Mailing Address - Fax:
Practice Address - Street 1:234 EAST 149TH STREET
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451
Practice Address - Country:US
Practice Address - Phone:718-579-5900
Practice Address - Fax:718-579-4620
Is Sole Proprietor?:No
Enumeration Date:2016-07-08
Last Update Date:2022-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3097932086S0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0102XAllopathic & Osteopathic PhysiciansSurgerySurgical Critical Care