Provider Demographics
NPI:1487780078
Name:MAYMAN, HAYA ILANA (MD)
Entity type:Individual
Prefix:
First Name:HAYA ILANA
Middle Name:
Last Name:MAYMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:266 MAIN ST
Mailing Address - Street 2:BLDG 1/SUITE 4/PO BOX 469
Mailing Address - City:MEDFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:02052-2043
Mailing Address - Country:US
Mailing Address - Phone:508-359-8141
Mailing Address - Fax:508-359-8005
Practice Address - Street 1:266 MAIN ST
Practice Address - Street 2:BLDG 1/SUITE 4
Practice Address - City:MEDFIELD
Practice Address - State:MA
Practice Address - Zip Code:02052-2043
Practice Address - Country:US
Practice Address - Phone:508-359-8141
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-26
Last Update Date:2012-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA60221207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
E17581Medicare UPIN