Eric Thomas Haley

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

633364 Issued in NY

Practice address

17 Sussex St # 19
Port Jervis, NY 12771-2430

Phone

(845) 856-6344

NPI assigned

May 1, 2018

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Catholic Charities of Orange, Sullivan & Ulster

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Goshen, NY
  • NPI 1093875007
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1525132800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1525132800000",
    "number": "1750879128",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27 MATTHEWS ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SUSSEX ST # 19",
            "city": "PORT JERVIS",
            "state": "NY",
            "postal_code": "127712430",
            "telephone_number": "845-856-6344"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALEY",
        "first_name": "ERIC",
        "middle_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-01",
        "last_updated": "2018-05-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "NY",
            "license": "633364",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Herbert M Green, MD
• Kimberly Greenfield
• Greenville Township Volunteer Ambulance Corps Inc
• Timothy Richard Gregory, LCSW
• Frances M Griffin, LCSW
• Toni Hall, CASAC
• Peter Hamilton, MD
• Natalie Hayes
• Henry R Goldstein MD PC
• Hillside Health Medical Practice, P.C.

• Registered Nurse in Port Jervis, NY
• Providers in Port Jervis, NY by specialty
• Registered Nurse in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.