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NPI Code Detail

MEDICARE: SHENITA DENISE HAYNES DPT

MEDICARE: SHENITA DENISE HAYNES DPT
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
1225100000XPhysical Therapist62029858NY

General Provider Information

NPI Number : 1336459833
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHENITA DENISE HAYNES DPT
Provider Business Mailing Address
First Line : 16 TED MILLER DR
Second Line :
City : MAYBROOK
State : NY
Zip : 12543-1135
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 622 W 168TH ST
Second Line :
City : NEW YORK
State : NY
Zip : 10032-3720
Country : US
Telephone Number : 212-305-3280
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/18/2010
Last Update Date : 10/18/2010

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Directions to “ SHENITA DENISE HAYNES DPT” Practice Location

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