Basic Information
| Provider Information | |||||||||
| NPI: | 1225001993 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HAYES | ||||||||
| FirstName: | MATTHEW | ||||||||
| MiddleName: | STEPHEN | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | D.O. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1824 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100353832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124234500 | ||||||||
| FaxNumber: | 6467708405 | ||||||||
| Practice Location | |||||||||
| Address1: | 1824 MADISON AVE | ||||||||
| Address2: | |||||||||
| City: | NEW YORK | ||||||||
| State: | NY | ||||||||
| PostalCode: | 100353832 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2124234500 | ||||||||
| FaxNumber: | 6467708405 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/10/2006 | ||||||||
| LastUpdateDate: | 02/11/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | 1262 | SC | N | Allopathic & Osteopathic Physicians | Family Medicine | 207Q00000X | 447 | NE | N | Allopathic & Osteopathic Physicians | Family Medicine | 207QS0010X | 2012-731 | NC | N | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine | 207QS0010X | 288256 | NY | Y | Allopathic & Osteopathic Physicians | Family Medicine | Sports Medicine |
No ID Information.