Provider Demographics
NPI:1184076978
Name:IOSUE, HAYLEY EDYTHE (DPM)
Entity type:Individual
Prefix:DR
First Name:HAYLEY
Middle Name:EDYTHE
Last Name:IOSUE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:HAYLEY
Other - Middle Name:EDYTHE
Other - Last Name:EBERSBACHER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DPM
Mailing Address - Street 1:7482 CENTER ST
Mailing Address - Street 2:UNIT 100
Mailing Address - City:MENTOR
Mailing Address - State:OH
Mailing Address - Zip Code:44060-5847
Mailing Address - Country:US
Mailing Address - Phone:440-357-8418
Mailing Address - Fax:
Practice Address - Street 1:27100 CHARDON RD
Practice Address - Street 2:
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44143-1116
Practice Address - Country:US
Practice Address - Phone:440-516-8704
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1354213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery