1881958536 NPI number — MS. ALICE MARY HAYLING MS. SP.EDU

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1881958536 NPI number — MS. ALICE MARY HAYLING MS. SP.EDU

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HAYLING
Provider First Name:
ALICE
Provider Middle Name:
MARY
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
MS. SP.EDU
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1881958536
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/27/2012
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5516 KINGS HWY
Provider Second Line Business Mailing Address:
BROOKLYN
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11203-5435
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-791-4135
Provider Business Mailing Address Fax Number:
718-629-2693

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5516 KINGS HWY
Provider Second Line Business Practice Location Address:
BROOKLYN
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11203-5435
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-791-4135
Provider Business Practice Location Address Fax Number:
718-629-2693
Provider Enumeration Date:
06/27/2012

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: 174400000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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