Provider Demographics
NPI:1417013459
Name:HAYDEN, STANLEY (PHD)
Entity Type:Individual
Prefix:DR
First Name:STANLEY
Middle Name:
Last Name:HAYDEN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12 BEEKMAN PL
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3604
Mailing Address - Country:US
Mailing Address - Phone:201-796-0114
Mailing Address - Fax:201-796-3432
Practice Address - Street 1:12 BEEKMAN PL
Practice Address - Street 2:
Practice Address - City:FAIR LAWN
Practice Address - State:NJ
Practice Address - Zip Code:07410-3604
Practice Address - Country:US
Practice Address - Phone:201-796-0114
Practice Address - Fax:201-796-3432
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ102103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJHA104109Medicare ID - Type Unspecified