Provider Demographics
NPI:1023411188
Name:HAYWARD, JOSHUA (CASAC)
Entity type:Individual
Prefix:
First Name:JOSHUA
Middle Name:
Last Name:HAYWARD
Suffix:
Gender:M
Credentials:CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1600 MACOMBS ROAD
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10452
Mailing Address - Country:US
Mailing Address - Phone:718-299-3300
Mailing Address - Fax:718-299-5905
Practice Address - Street 1:1600 MACOMBS RD
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10452-2016
Practice Address - Country:US
Practice Address - Phone:718-299-3300
Practice Address - Fax:718-299-5905
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-03
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes324500000XResidential Treatment FacilitiesSubstance Abuse Rehabilitation Facility