Provider Demographics
NPI:1295724474
Name:HAYMES, ALLYSON A (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ALLYSON
Middle Name:A
Last Name:HAYMES
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4300 EMERALD HILL CIR
Mailing Address - Street 2:
Mailing Address - City:CANANDAIGUA
Mailing Address - State:NY
Mailing Address - Zip Code:14424-8166
Mailing Address - Country:US
Mailing Address - Phone:585-489-9676
Mailing Address - Fax:716-839-3338
Practice Address - Street 1:4300 EMERALD HILL CIR
Practice Address - Street 2:
Practice Address - City:CANANDAIGUA
Practice Address - State:NY
Practice Address - Zip Code:14424-8166
Practice Address - Country:US
Practice Address - Phone:585-489-9676
Practice Address - Fax:716-839-3338
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2013-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2344672085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00364181Medicaid
RA7667Medicare PIN
NYH07729Medicare UPIN