Healthcare Provider Details

I. General information

NPI: 1528560570
Provider Name (Legal Business Name): ROBERT LEWIS HUTCHINSON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2018
Last Update Date: 03/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1609 STUYVESANT AVENUE
WEST TRENTON NJ
08628
US

IV. Provider business mailing address

1211 WHITE PINE CIR
LAWRENCEVILLE NJ
08648-2929
US

V. Phone/Fax

Practice location:
  • Phone: 609-633-0859
  • Fax:
Mailing address:
  • Phone: 609-647-1369
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number26NO10284700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: