Provider Demographics
NPI:1316770142
Name:BYERS, HAYLEY TUCKER
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:TUCKER
Last Name:BYERS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2434 BERLIN TPKE STE 14
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-4122
Mailing Address - Country:US
Mailing Address - Phone:860-687-9700
Mailing Address - Fax:860-422-4632
Practice Address - Street 1:2434 BERLIN TPKE STE 14
Practice Address - Street 2:
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-4122
Practice Address - Country:US
Practice Address - Phone:860-687-9700
Practice Address - Fax:860-422-4632
Is Sole Proprietor?:No
Enumeration Date:2024-08-26
Last Update Date:2024-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT14625225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist