Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 135134-1 | NY |
N | 208000000X | Pediatrician | 25MA05720500 | NJ |
N | 2080P0208X | Pediatric Infectious Diseases | 135134-1 | NY |
N | 2080P0208X | Pediatric Infectious Diseases | 25MA05720500 | NJ |
NPI | 1578503595 |
---|---|
Provider Name | Dr. Alexander C. Hyatt |
First Address | Englewood, NJ 07631-1808 |
Second Address | Englewood, NJ 07631-1808 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/06/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
01421705 | (05) | NY |
5125901 | (05) | NJ |
B19477 | (02) |