Provider Demographics
NPI:1730160235
Name:HAYES, PAUL GERARD (OTR)
Entity type:Individual
Prefix:MR
First Name:PAUL
Middle Name:GERARD
Last Name:HAYES
Suffix:
Gender:M
Credentials:OTR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 OLD BEAVER RUN RD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:NJ
Mailing Address - Zip Code:07848-2004
Mailing Address - Country:US
Mailing Address - Phone:973-579-7870
Mailing Address - Fax:
Practice Address - Street 1:225 STATE ROUTE 10 E
Practice Address - Street 2:SUITE 102
Practice Address - City:SUCCASUNNA
Practice Address - State:NJ
Practice Address - Zip Code:07876-1300
Practice Address - Country:US
Practice Address - Phone:973-927-7112
Practice Address - Fax:973-927-7996
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00022900225XH1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225XH1200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational TherapistHand
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ066054Medicare ID - Type UnspecifiedOCCUPATIONAL THERAPIST