Provider Demographics
NPI:1720840531
Name:A HAYES, JUSTIN A
Entity Type:Individual
Prefix:
First Name:JUSTIN
Middle Name:A
Last Name:A HAYES
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8616 SAPIENZA DR
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-1229
Mailing Address - Country:US
Mailing Address - Phone:202-894-5697
Mailing Address - Fax:
Practice Address - Street 1:2124 MARTIN LUTHER KING JR AVE SE
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20020-5732
Practice Address - Country:US
Practice Address - Phone:202-894-5697
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-26
Last Update Date:2024-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator