Provider Demographics
NPI:1699421933
Name:HAYES, JULIANNE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JULIANNE
Middle Name:
Last Name:HAYES
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27 FOX HOLLOW RIDINGS RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-2244
Mailing Address - Country:US
Mailing Address - Phone:631-374-0941
Mailing Address - Fax:
Practice Address - Street 1:755 PARK AVE STE 140
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-3972
Practice Address - Country:US
Practice Address - Phone:631-374-0941
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-02-24
Last Update Date:2022-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY024354103TB0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TB0200XBehavioral Health & Social Service ProvidersPsychologistCognitive & Behavioral