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General NPI Number Information
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NPI Number | 1790338382
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Entity Type | Individual
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Provider Name | DIANE HAYNES
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Gender | Female
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Dates
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Enumeration Date | 07/23/2019
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Last Update Date | 03/31/2026
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Provider Practice Location Address
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Address Line | 3712 PRINCE ST STE 3C
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City | FLUSHING
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State | NY
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Zip | 11354-4650
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Country | US
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Telephone | 718-380-7800
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Fax |
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Provider Business Mailing Address
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Address Line | 419 COOLIDGE AVE
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City | ROCKVILLE CENTRE
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State | NY
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Zip | 11570-3307
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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 | 358027
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 708471
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License Number State | NY
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