Provider Demographics
NPI:1609080027
Name:HAYES, EARLE W (DO)
Entity Type:Individual
Prefix:DR
First Name:EARLE
Middle Name:W
Last Name:HAYES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O BOX 95000-2433
Mailing Address - Street 2:
Mailing Address - City:PA
Mailing Address - State:PA
Mailing Address - Zip Code:19195-3354
Mailing Address - Country:US
Mailing Address - Phone:212-420-2377
Mailing Address - Fax:
Practice Address - Street 1:1ST AVE 16TH STREET
Practice Address - Street 2:12 BAIRD HALL
Practice Address - City:NY
Practice Address - State:NY
Practice Address - Zip Code:10003-3354
Practice Address - Country:US
Practice Address - Phone:212-420-2377
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-09
Last Update Date:2013-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY230591207RC0200X, 207RH0002X
FLOS9590207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine