Healthcare Provider Details

I. General information

NPI: 1730187246
Provider Name (Legal Business Name): TIMOTHY JOSEPH HAYES DC
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/08/2005
Last Update Date: 12/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 W MAIN ST SUITE 105
FREEHOLD NJ
07728-2554
US

IV. Provider business mailing address

800 W MAIN ST STE 105
FREEHOLD NJ
07728-2555
US

V. Phone/Fax

Practice location:
  • Phone: 732-577-9700
  • Fax: 732-577-9790
Mailing address:
  • Phone: 732-577-9700
  • Fax: 732-577-9790

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number38MC00265700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: