Provider Demographics
NPI:1184687238
Name:HAYWARD, RICHARD (PT,OMPT,OCS,CEES)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:PT,OMPT,OCS,CEES
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34434 KING STREET ROW
Mailing Address - Street 2:SUITE 1
Mailing Address - City:LEWES
Mailing Address - State:DE
Mailing Address - Zip Code:19958-4787
Mailing Address - Country:US
Mailing Address - Phone:302-645-0312
Mailing Address - Fax:302-645-0342
Practice Address - Street 1:34434 KING STREET ROW
Practice Address - Street 2:SUITE 1
Practice Address - City:LEWES
Practice Address - State:DE
Practice Address - Zip Code:19958-4787
Practice Address - Country:US
Practice Address - Phone:302-645-0312
Practice Address - Fax:302-645-0342
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2008-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEJ10001504225100000X, 2251E1200X, 2251G0304X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251E1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistErgonomics
No2251G0304XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGeriatrics
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
DE2622967000OtherAMERIHEALTH
DE011719S93Medicare ID - Type Unspecified
DEP89772Medicare UPIN