Basic Information
| Provider Information | |||||||||
| NPI: | 1922017342 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HAYNES-LAING | ||||||||
| FirstName: | ARLEEN | ||||||||
| MiddleName: | G | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 N 20TH ST | ||||||||
| Address2: | CHCA SUITE 301 | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191031443 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2155672422 | ||||||||
| FaxNumber: | 2155610959 | ||||||||
| Practice Location | |||||||||
| Address1: | 800 SPRUCE ST FL 2 | ||||||||
| Address2: | PENNSYLVANIA HOSPITAL - CHOP NEWBORN PEDIATRICS | ||||||||
| City: | PHILADELPHIA | ||||||||
| State: | PA | ||||||||
| PostalCode: | 191076130 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2158293191 | ||||||||
| FaxNumber: | 2155610959 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/05/2006 | ||||||||
| LastUpdateDate: | 06/22/2010 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208000000X | MD044094L | PA | N | Allopathic & Osteopathic Physicians | Pediatrics | 2080N0001X | MD044094L | PA | Y | Allopathic & Osteopathic Physicians | Pediatrics | Neonatal-Perinatal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 001488973 | 05 | PA | MEDICAID | 7563108 | 05 | NJ | MEDICAID |