Healthcare Provider Details

I. General information

NPI: 1629775978
Provider Name (Legal Business Name): LAUREN MARIE HAYES
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/07/2023
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 CUMMINGS CTR STE 166D
BEVERLY MA
01915-6135
US

IV. Provider business mailing address

16 CAMILLE RD
REVERE MA
02151-2177
US

V. Phone/Fax

Practice location:
  • Phone: 978-712-3360
  • Fax:
Mailing address:
  • Phone: 617-957-8076
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number26701
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: