Provider Demographics
NPI:1215026604
Name:HAYECK, ANDREA S (DDS)
Entity Type:Individual
Prefix:MRS
First Name:ANDREA
Middle Name:S
Last Name:HAYECK
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N WOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07036-4037
Mailing Address - Country:US
Mailing Address - Phone:908-486-5300
Mailing Address - Fax:908-486-6213
Practice Address - Street 1:801 N WOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDEN
Practice Address - State:NJ
Practice Address - Zip Code:07036-4037
Practice Address - Country:US
Practice Address - Phone:908-486-5300
Practice Address - Fax:908-486-6213
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI187231223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice