Provider Demographics
NPI:1316975147
Name:HAYES, JENNIFER ANNE (MPT)
Entity type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:ANNE
Last Name:HAYES
Suffix:
Gender:F
Credentials:MPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:717 SHERWOOD DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSTOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:08094-1677
Mailing Address - Country:US
Mailing Address - Phone:856-262-8641
Mailing Address - Fax:
Practice Address - Street 1:570 EGG HARBOR RD
Practice Address - Street 2:SUITE B6
Practice Address - City:SEWELL
Practice Address - State:NJ
Practice Address - Zip Code:08080-2359
Practice Address - Country:US
Practice Address - Phone:856-218-8050
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-29
Last Update Date:2008-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QA00904500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist