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General NPI Number Information
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NPI Number | 1053544775
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Entity Type | Individual
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Provider Name | MICHELLE THURLOW
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Gender | Female
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Dates
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Enumeration Date | 08/27/2009
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Last Update Date | 08/07/2020
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Provider Practice Location Address
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Address Line | 95 MADISON AVE
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City | MORRISTOWN
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State | NJ
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Zip | 07960-6092
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Country | US
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Telephone | 908-389-6340
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Fax |
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Provider Business Mailing Address
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Address Line | 1 DIAMOND HILL RD
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City | BERKELEY HEIGHTS
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State | NJ
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Zip | 07922-2104
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Country | US
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Telephone | 908-273-4300
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AS0400X
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Taxonomy Name | Surgical Physician Assistant
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License Number | 25MP00219700
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License Number State | NJ
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