Provider Demographics
NPI:1447485065
Name:HAYDUK, LENORA
Entity type:Individual
Prefix:
First Name:LENORA
Middle Name:
Last Name:HAYDUK
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 1:283 BUTLER RD
Mailing Address - Street 2:
Mailing Address - City:MOUNT GRETNA
Mailing Address - State:PA
Mailing Address - Zip Code:17064-6085
Mailing Address - Country:US
Mailing Address - Phone:717-821-7974
Mailing Address - Fax:717-270-2444
Practice Address - Street 1:283 BUTLER RD
Practice Address - Street 2:
Practice Address - City:MOUNT GRETNA
Practice Address - State:PA
Practice Address - Zip Code:17064-6085
Practice Address - Country:US
Practice Address - Phone:717-821-7974
Practice Address - Fax:717-270-2444
Is Sole Proprietor?:No
Enumeration Date:2009-05-27
Last Update Date:2014-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker