MEDICARE: DENASIA HAYES LPN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	164W00000X	Licensed Practical Nurse	297590-1	NY

General Provider Information

NPI Number	:	1235451758
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DENASIA HAYES LPN

Provider Business Mailing Address
First Line	:	32 WARD HILL RD
Second Line	:
City	:	HENRIETTA
State	:	NY
Zip	:	14467-9762
Country	:	US
Telephone Number	:	585-486-4632
Fax Number	:

Provider Business Practice Location Address
First Line	:	32 WARD HILL RD
Second Line	:
City	:	HENRIETTA
State	:	NY
Zip	:	14467-9762
Country	:	US
Telephone Number	:	585-486-4632
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/25/2010
Last Update Date	:	02/25/2010

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