Individual
BEVERLY HAYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
400 FOREST AVE, BUFFALO, NY 14213-1207
(716) 816-2959
(716) 816-2207
Mailing address
64 KENEFICK AVE, BUFFALO, NY 14220-1520
(716) 478-2151
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
267505-01
NY
Other
Enumeration date
01/11/2024
Last updated
01/11/2024
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