Provider Demographics
NPI:1881626190
Name:HAYDEN, ANTHONY J (MD)
Entity type:Individual
Prefix:
First Name:ANTHONY
Middle Name:J
Last Name:HAYDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 HIGHLAND AVE
Mailing Address - Street 2:RADIOLOGY DEPARTMENT
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-3867
Mailing Address - Country:US
Mailing Address - Phone:978-463-1120
Mailing Address - Fax:978-463-1171
Practice Address - Street 1:25 HIGHLAND AVE
Practice Address - Street 2:RADIOLOGY DEPARTMENT
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-3867
Practice Address - Country:US
Practice Address - Phone:978-463-1120
Practice Address - Fax:978-463-1171
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0562762085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30008644Medicaid
MA3012000Medicaid
NH30008644Medicaid
A58530Medicare UPIN