Provider Demographics
NPI:1306970710
Name:HAYSER, JOHN PATRICK (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:PATRICK
Last Name:HAYSER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:AVON BY THE SEA
Mailing Address - State:NJ
Mailing Address - Zip Code:07717-1020
Mailing Address - Country:US
Mailing Address - Phone:732-774-8085
Mailing Address - Fax:
Practice Address - Street 1:618 MAIN ST
Practice Address - Street 2:
Practice Address - City:AVON BY THE SEA
Practice Address - State:NJ
Practice Address - Zip Code:07717-1020
Practice Address - Country:US
Practice Address - Phone:732-774-8085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-15
Last Update Date:2011-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ38MC00604900111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0770177Medicare ID - Type Unspecified