Provider Demographics
NPI:1265980338
Name:HAYDEN, MELISSA ANNE (PA-C)
Entity type:Individual
Prefix:
First Name:MELISSA
Middle Name:ANNE
Last Name:HAYDEN
Suffix:
Gender:
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:184 BARTON ST
Mailing Address - Street 2:
Mailing Address - City:BUFFALO
Mailing Address - State:NY
Mailing Address - Zip Code:14213-1573
Mailing Address - Country:US
Mailing Address - Phone:716-881-6191
Mailing Address - Fax:716-881-6247
Practice Address - Street 1:184 BARTON ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14213-1573
Practice Address - Country:US
Practice Address - Phone:716-881-6191
Practice Address - Fax:716-881-6247
Is Sole Proprietor?:No
Enumeration Date:2016-09-16
Last Update Date:2025-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY026941363A00000X
IA101165363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant