Healthcare Provider Details

I. General information

NPI: 1114995990
Provider Name (Legal Business Name): CHERIE JEAN HAYOSTEK MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHERIE JEAN LINDEN

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/08/2020
Certification Date: 09/08/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

MSC07-4025, 1 UNIVERSITY OF NEW MEXICO
ALBUQUERQUE NM
87131-5141
US

IV. Provider business mailing address

933 BRADBURY DR SE STE 2222
ALBUQUERQUE NM
87106-4375
US

V. Phone/Fax

Practice location:
  • Phone: 505-272-4946
  • Fax: 505-925-0100
Mailing address:
  • Phone: 505-272-1320
  • Fax: 505-272-8060

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD2005-0488
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: