Healthcare Provider Details

I. General information

NPI: 1942278445
Provider Name (Legal Business Name): GEORGE HAYAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 03/07/2023
Certification Date: 02/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

41 MALL RD LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON MA
01805-0001
US

IV. Provider business mailing address

41 MALL RD LAHEY HOSPITAL AND MEDICAL CENTER
BURLINGTON MA
01805-0001
US

V. Phone/Fax

Practice location:
  • Phone: 781-744-3839
  • Fax: 781-744-1597
Mailing address:
  • Phone: 781-744-3839
  • Fax: 781-744-1597

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number70875
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number70675
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: