Provider Demographics
NPI:1053926675
Name:HAYT, JULIETTE R
Entity type:Individual
Prefix:
First Name:JULIETTE
Middle Name:R
Last Name:HAYT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 BEDFORD AVE APT A506
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11211-3221
Mailing Address - Country:US
Mailing Address - Phone:516-574-1597
Mailing Address - Fax:
Practice Address - Street 1:2 W 45TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10036-4212
Practice Address - Country:US
Practice Address - Phone:212-920-1976
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-10
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYP106554221700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist