Healthcare Provider Details

I. General information

NPI: 1487300240
Provider Name (Legal Business Name): DANIEL JOSEPH HAYEK PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/01/2022
Last Update Date: 03/18/2025
Certification Date: 03/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 LOUISIANA BLVD NE STE 410
ALBUQUERQUE NM
87110-5412
US

IV. Provider business mailing address

UNM SCHOOL OF MEDICINE MSC 4720 1UNM
ALBUQUERQUE NM
87131
US

V. Phone/Fax

Practice location:
  • Phone: 505-724-4300
  • Fax: 505-724-4384
Mailing address:
  • Phone: 505-272-2321
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2022-0113
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: