Provider Demographics
NPI:1568531713
Name:HAYES, SEAN J (MSPT)
Entity Type:Individual
Prefix:MR
First Name:SEAN
Middle Name:J
Last Name:HAYES
Suffix:
Gender:M
Credentials:MSPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:60 ROUTE 25A
Mailing Address - Street 2:
Mailing Address - City:SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-2848
Mailing Address - Country:US
Mailing Address - Phone:631-246-6072
Mailing Address - Fax:631-246-6074
Practice Address - Street 1:60 ROUTE 25A
Practice Address - Street 2:
Practice Address - City:SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-2848
Practice Address - Country:US
Practice Address - Phone:631-246-6072
Practice Address - Fax:631-246-6074
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2009-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY019404-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYQ15Q51Medicare PIN