Provider Demographics
NPI:1629089503
Name:HAYES, JOSEPH J (CRNA)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:J
Last Name:HAYES
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 SILVER RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:YORK
Mailing Address - State:ME
Mailing Address - Zip Code:03909-5796
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:216 LOGAN LN
Practice Address - Street 2:
Practice Address - City:MAHOPAC
Practice Address - State:NY
Practice Address - Zip Code:10541-3650
Practice Address - Country:US
Practice Address - Phone:888-400-8878
Practice Address - Fax:845-621-1911
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2011-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT101-0023776367500000X
VA0024167564367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT0VN2461Medicaid
NH30343218Medicaid
VAVAA113098Medicare PIN
VT0VN2461Medicaid