Provider Demographics
NPI:1225001993
Name:HAYES, MATTHEW STEPHEN (DO)
Entity type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:STEPHEN
Last Name:HAYES
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1824 MADISON AVE
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10035-3832
Mailing Address - Country:US
Mailing Address - Phone:212-423-4500
Mailing Address - Fax:646-770-8405
Practice Address - Street 1:1824 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10035-3832
Practice Address - Country:US
Practice Address - Phone:212-423-4500
Practice Address - Fax:646-770-8405
Is Sole Proprietor?:No
Enumeration Date:2006-02-10
Last Update Date:2019-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC1262207Q00000X
NE447207Q00000X
NC2012-731207QS0010X
NY288256207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine