1922570779 NPI number — DR. HAYLEE MORGAN KIEHART DC

Table of content: (NPI 1578089322)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1922570779 NPI number — DR. HAYLEE MORGAN KIEHART DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIEHART
Provider First Name:
HAYLEE
Provider Middle Name:
MORGAN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
MEVORAH
Provider Other First Name:
HAYLEE
Provider Other Middle Name:
MORGAN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
DC
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1922570779
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2757 LOWER LAKE RD APT B
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SENECA FALLS
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
13148-9429
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
732-343-0318
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
216 MONTOUR ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MONTOUR FALLS
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
14865-9669
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
607-535-6094
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/18/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  X013186-1 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)