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General NPI Number Information
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NPI Number | 1114127958
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Entity Type | Organization
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Legal Business Name | TIMOTHY P. HAYES, PH.D., CLINICAL PSYCHOLOGIST, P.C.
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Dates
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Enumeration Date | 07/19/2007
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Last Update Date | 02/22/2008
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Provider Practice Location Address
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Address Line | 315 S CROUSE AVE SUITE 301
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City | SYRACUSE
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State | NY
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Zip | 13210-1845
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Country | US
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Telephone | 315-422-1722
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Fax | 315-422-1741
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Provider Business Mailing Address
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Address Line | 315 S CROUSE AVE SUITE 301
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City | SYRACUSE
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State | NY
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Zip | 13210-1845
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Country | US
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Telephone | 315-422-1722
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Fax | 315-422-1741
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. TIMOTHY P. HAYES
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Credential | PH.D.
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Telephone | 315-422-1722
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | 012381
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License Number State | NY
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