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General NPI Number Information
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NPI Number | 1639091390
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Entity Type | Individual
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Provider Name | THERESA ANNE HAYDEN
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Gender | Female
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Dates
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Enumeration Date | 07/27/2026
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Last Update Date | 07/27/2026
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Provider Practice Location Address
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Address Line | 1 EAGLE ST APT 1602
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City | BROOKLYN
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State | NY
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Zip | 11222-7752
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Country | US
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Telephone | 973-980-1296
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Fax |
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Provider Business Mailing Address
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Address Line | 29 OAK LN
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City | WAYNE
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State | NJ
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Zip | 07470-3426
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 354817
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License Number State | NY
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