Healthcare Provider Details

I. General information

NPI: 1710813381
Provider Name (Legal Business Name): CREIG BRUCE HAYES FNP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2026
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

250 DELAWARE AVE STE 100
DELMAR NY
12054-1402
US

IV. Provider business mailing address

6 WELLNESS WAY STE 201
LATHAM NY
12110-2156
US

V. Phone/Fax

Practice location:
  • Phone: 518-439-8077
  • Fax: 518-439-8070
Mailing address:
  • Phone: 518-782-3700
  • Fax: 518-782-3799

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberF360038
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: