Provider Demographics
NPI:1538725494
Name:HAYDEN, SAKINA STARR (NP)
Entity type:Individual
Prefix:
First Name:SAKINA
Middle Name:STARR
Last Name:HAYDEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 152
Mailing Address - Street 2:
Mailing Address - City:DEER PARK
Mailing Address - State:NY
Mailing Address - Zip Code:11729-0152
Mailing Address - Country:US
Mailing Address - Phone:631-609-0562
Mailing Address - Fax:
Practice Address - Street 1:1488 DEER PARK AVE # 357
Practice Address - Street 2:
Practice Address - City:NORTH BABYLON
Practice Address - State:NY
Practice Address - Zip Code:11703-1208
Practice Address - Country:US
Practice Address - Phone:646-434-6238
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-05-16
Last Update Date:2020-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY403231363LP0808X
NY722641163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse