Provider Demographics
NPI:1952341901
Name:HAYDON, LAURA (PT, DPT, CLT)
Entity Type:Individual
Prefix:MRS
First Name:LAURA
Middle Name:
Last Name:HAYDON
Suffix:
Gender:F
Credentials:PT, DPT, CLT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 RESEARCH WAY
Mailing Address - Street 2:
Mailing Address - City:EAST SETAUKET
Mailing Address - State:NY
Mailing Address - Zip Code:11733-3489
Mailing Address - Country:US
Mailing Address - Phone:631-444-4240
Mailing Address - Fax:631-444-4713
Practice Address - Street 1:33 RESEARCH WAY
Practice Address - Street 2:
Practice Address - City:EAST SETAUKET
Practice Address - State:NY
Practice Address - Zip Code:11733-3489
Practice Address - Country:US
Practice Address - Phone:631-444-4240
Practice Address - Fax:631-444-4713
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-07
Last Update Date:2019-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY016939225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist