Provider Demographics
NPI:1285707588
Name:HAYES-HARDING, MARTHA J (NP)
Entity type:Individual
Prefix:
First Name:MARTHA
Middle Name:J
Last Name:HAYES-HARDING
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 1:550 DUNNBRIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WEBSTER
Mailing Address - State:NY
Mailing Address - Zip Code:14580-1573
Mailing Address - Country:US
Mailing Address - Phone:585-670-9093
Mailing Address - Fax:
Practice Address - Street 1:855 W MAIN ST
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14611-2335
Practice Address - Country:US
Practice Address - Phone:585-753-5481
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF380823-1363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner