Provider Demographics
NPI:1942275169
Name:HAYES, GERARD B (MD)
Entity Type:Individual
Prefix:
First Name:GERARD
Middle Name:B
Last Name:HAYES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:11 NEVINS ST
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:MA
Mailing Address - Zip Code:02135-3514
Mailing Address - Country:US
Mailing Address - Phone:617-789-2548
Mailing Address - Fax:617-562-7736
Practice Address - Street 1:736 CAMBRIDGE ST
Practice Address - Street 2:3RD FLOOR SETON PAVILLION
Practice Address - City:BRIGHTON
Practice Address - State:MA
Practice Address - Zip Code:02135
Practice Address - Country:US
Practice Address - Phone:617-789-2548
Practice Address - Fax:617-562-7736
Is Sole Proprietor?:No
Enumeration Date:2006-02-21
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA79628207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3134750Medicaid
MAJ30962Medicare ID - Type Unspecified
MA3134750Medicaid