Provider Demographics
NPI:1609503325
Name:HAYES, BENJAMIN C (NP)
Entity Type:Individual
Prefix:
First Name:BENJAMIN
Middle Name:C
Last Name:HAYES
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 BRIGAM LN
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-6693
Mailing Address - Country:US
Mailing Address - Phone:845-705-9409
Mailing Address - Fax:
Practice Address - Street 1:19 BRIGAM LN
Practice Address - Street 2:
Practice Address - City:HOPEWELL JUNCTION
Practice Address - State:NY
Practice Address - Zip Code:12533-6693
Practice Address - Country:US
Practice Address - Phone:845-705-9409
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-03
Last Update Date:2022-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF347628363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily