Healthcare Provider Details

I. General information

NPI: 1073078416
Provider Name (Legal Business Name): DANIEL HAYWOOD MA, RDT, LCAT
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2019
Last Update Date: 12/07/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

112 W 27TH ST STE 402
NEW YORK NY
10001-6241
US

IV. Provider business mailing address

1143 30TH RD FL 2
ASTORIA NY
11102-4032
US

V. Phone/Fax

Practice location:
  • Phone: 347-776-0391
  • Fax:
Mailing address:
  • Phone: 347-776-0391
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code221700000X
TaxonomyArt Therapist
License Number001688-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: