Provider Demographics
NPI:1124069562
Name:NORMAN HAYWOOD D.O.,P. C.
Entity type:Organization
Organization Name:NORMAN HAYWOOD D.O.,P. C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:NORMAN
Authorized Official - Middle Name:
Authorized Official - Last Name:HAYWOOD
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:631-226-0011
Mailing Address - Street 1:224 N WELLWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:LINDENHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11757-3705
Mailing Address - Country:US
Mailing Address - Phone:631-226-0011
Mailing Address - Fax:631-226-1611
Practice Address - Street 1:224 N WELLWOOD AVE
Practice Address - Street 2:
Practice Address - City:LINDENHURST
Practice Address - State:NY
Practice Address - Zip Code:11757-3705
Practice Address - Country:US
Practice Address - Phone:631-226-0011
Practice Address - Fax:631-226-1611
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-09
Last Update Date:2008-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY194315174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY5404162OtherAETNA
NY6100704OtherGHI
NY01540532Medicaid
NY1228381P01OtherCIGNA
NY4C1803OtherHEALTHNET/ACS
NY79920OtherVYTRA
NYHIP02061OtherHIP HERITAGE
NYP391810OtherOXFORD
NY38726OtherCONN GENERAL
NY1228381P01OtherCIGNA
NY4C1803OtherHEALTHNET/ACS