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General NPI Number Information
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NPI Number | 1770593576
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Entity Type | Individual
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Provider Name | AMY B HATOK P.A.
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Gender | Female
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Dates
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Enumeration Date | 08/08/2006
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Last Update Date | 09/27/2012
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Provider Practice Location Address
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Address Line | 860 OMNI BLVD SUITE 101
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4430
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Country | US
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Telephone | 757-877-4221
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Fax | 757-886-1042
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Provider Business Mailing Address
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Address Line | 860 OMNI BLVD SUITE 303
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City | NEWPORT NEWS
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State | VA
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Zip | 23606-4430
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Country | US
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Telephone | 757-232-8777
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Fax | 757-232-8866
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 0110001010
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License Number State | VA
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