Healthcare Provider Details

I. General information

NPI: 1730160235
Provider Name (Legal Business Name): PAUL GERARD HAYES OTR
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

225 STATE ROUTE 10 E SUITE 102
SUCCASUNNA NJ
07876-1300
US

IV. Provider business mailing address

80 OLD BEAVER RUN RD
LAFAYETTE NJ
07848-2004
US

V. Phone/Fax

Practice location:
  • Phone: 973-927-7112
  • Fax: 973-927-7996
Mailing address:
  • Phone: 973-579-7870
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225XH1200X
TaxonomyHand Occupational Therapist
License Number46TR00022900
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: