Provider Demographics
NPI:1578503595
Name:HYATT, ALEXANDER C (MD)
Entity Type:Individual
Prefix:DR
First Name:ALEXANDER
Middle Name:C
Last Name:HYATT
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Mailing Address - Street 1:350 ENGLE ST
Mailing Address - Street 2:ENGLEWOOD HOSPITAL AND MEDICAL CENTER
Mailing Address - City:ENGLEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:07631-1808
Mailing Address - Country:US
Mailing Address - Phone:201-894-3158
Mailing Address - Fax:201-569-5983
Practice Address - Street 1:350 ENGLE ST
Practice Address - Street 2:ENGLEWOOD HOSPITAL AND MEDICAL CENTER
Practice Address - City:ENGLEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:07631-1808
Practice Address - Country:US
Practice Address - Phone:201-894-3158
Practice Address - Fax:201-569-5983
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA05720500208000000X, 2080P0208X
NY135134-1208000000X, 2080P0208X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatrics
Not Answered2080P0208XAllopathic & Osteopathic PhysiciansPediatricsPediatric Infectious Diseases
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01421705Medicaid
NJ5125901Medicaid
B19477Medicare UPIN