Provider Demographics
NPI:1649346958
Name:HAYTHE, JENNIFER HADEN (MD)
Entity type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:HADEN
Last Name:HAYTHE
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:173 FORT WASHINGTON AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10032-3741
Mailing Address - Country:US
Mailing Address - Phone:212-305-4600
Mailing Address - Fax:212-305-7439
Practice Address - Street 1:173 FORT WASHINGTON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10032-3739
Practice Address - Country:US
Practice Address - Phone:212-305-4600
Practice Address - Fax:212-305-7439
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2025-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY226891207RA0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RA0001XAllopathic & Osteopathic PhysiciansInternal MedicineAdvanced Heart Failure and Transplant Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02407472Medicaid
NY02407472Medicaid
NY86S251Medicare ID - Type Unspecified