Provider Demographics
NPI:1326056623
Name:HAYES, LESLIE A (MD)
Entity Type:Individual
Prefix:DR
First Name:LESLIE
Middle Name:A
Last Name:HAYES
Suffix:
Gender:F
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:PO BOX 5444
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10087-5444
Mailing Address - Country:US
Mailing Address - Phone:718-780-5268
Mailing Address - Fax:718-780-3266
Practice Address - Street 1:263 7TH AVE
Practice Address - Street 2:3RD FLOOR - PEDIATRICS
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11215-7247
Practice Address - Country:US
Practice Address - Phone:718-780-5268
Practice Address - Fax:718-780-3266
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-03
Last Update Date:2013-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY186473174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01297956Medicaid
F20748Medicare UPIN