Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 298951-1 | NY |
Y | 111NI0900X | Internist | 298951-1 | NY |
NPI | 1003262015 |
---|---|
Provider Name | Benjamin Tuttle Hayes |
First Address | Bronx, NY 10451-3535 |
Second Address | Bronx, NY 10451-3535 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/05/2016 |
Last Update Date | 12/02/2020 |