Provider Demographics
NPI:1982148292
Name:HAY-HAUGHTON, JOAN CECENIA
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:CECENIA
Last Name:HAY-HAUGHTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 N 3RD AVE
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:NY
Mailing Address - Zip Code:10550-1363
Mailing Address - Country:US
Mailing Address - Phone:914-371-1827
Mailing Address - Fax:914-371-1827
Practice Address - Street 1:110 N 3RD AVE
Practice Address - Street 2:
Practice Address - City:MOUNT VERNON
Practice Address - State:NY
Practice Address - Zip Code:10550-1363
Practice Address - Country:US
Practice Address - Phone:914-371-1827
Practice Address - Fax:914-371-1827
Is Sole Proprietor?:Yes
Enumeration Date:2016-12-06
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPN5220430164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse