Provider Demographics
NPI:1710547757
Name:RICARD, HAYLEY CHESSON (PA-C)
Entity type:Individual
Prefix:
First Name:HAYLEY
Middle Name:CHESSON
Last Name:RICARD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 CHICKERING RD
Mailing Address - Street 2:
Mailing Address - City:SPENCER
Mailing Address - State:MA
Mailing Address - Zip Code:01562-2822
Mailing Address - Country:US
Mailing Address - Phone:508-735-2943
Mailing Address - Fax:
Practice Address - Street 1:2 ADAMS PL STE 305
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02169-7456
Practice Address - Country:US
Practice Address - Phone:617-302-4194
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-20
Last Update Date:2020-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program