Provider Demographics
NPI:1275523649
Name:HAYDA, ROMAN ARTYM (MD)
Entity Type:Individual
Prefix:
First Name:ROMAN
Middle Name:ARTYM
Last Name:HAYDA
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 1:2 DUDLEY STREET, SUITE 200
Mailing Address - Street 2:UNIVERSITY ORTHOPEDICS, INC.
Mailing Address - City:PROVIDENCE
Mailing Address - State:RI
Mailing Address - Zip Code:02905
Mailing Address - Country:US
Mailing Address - Phone:401-457-1555
Mailing Address - Fax:401-831-8992
Practice Address - Street 1:2 DUDLEY ST
Practice Address - Street 2:SUITE 200
Practice Address - City:PROVIDENCE
Practice Address - State:RI
Practice Address - Zip Code:02905-3236
Practice Address - Country:US
Practice Address - Phone:401-457-1555
Practice Address - Fax:401-831-8992
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-26
Last Update Date:2011-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101046976207X00000X
RI12718207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
RI12718OtherSTATE LICENSE