Healthcare Provider Details

I. General information

NPI: 1538162235
Provider Name (Legal Business Name): JOHN J LAYDEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/27/2005
Last Update Date: 07/29/2021
Certification Date: 07/05/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 HEARTS WAY ADIRONDACK CARDIOLOGY
QUEENSBURY NY
12804-5925
US

IV. Provider business mailing address

100 PARK STREET GLENS FALLS HOSPITAL - CREDENTIALING
GLENS FALLS NY
12801-4413
US

V. Phone/Fax

Practice location:
  • Phone: 518-792-1233
  • Fax: 518-792-6854
Mailing address:
  • Phone: 518-926-5924
  • Fax: 518-926-6983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number169437
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: