MEDICARE: JOSEPH J HAYES CRNA

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	367500000X	Certified Registered Nurse Anesthetist	101-0023776	VT
2	367500000X	Certified Registered Nurse Anesthetist	0024167564	VA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1629089503
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOSEPH J HAYES CRNA

Provider Business Mailing Address
First Line	:	4 SILVER RIDGE DR
Second Line	:
City	:	YORK
State	:	ME
Zip	:	03909-5796
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	216 LOGAN LN
Second Line	:
City	:	MAHOPAC
State	:	NY
Zip	:	10541-3650
Country	:	US
Telephone Number	:	888-400-8878
Fax Number	:	845-621-1911

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

Provider Enumeration Date	:	08/10/2006
Last Update Date	:	03/14/2011

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