MEDICARE: DR. CLIFF SCOTT HAMILTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0804X	Child & Adolescent Psychiatry Physician	MD451246	PA
2	2084P0804X	Child & Adolescent Psychiatry Physician	25MA09599700	NJ

General Provider Information

NPI Number	:	1487991105
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CLIFF SCOTT HAMILTON M.D.

Provider Business Mailing Address
First Line	:	PO BOX 416457
Second Line	:
City	:	BOSTON
State	:	MA
Zip	:	02241-6457
Country	:	US
Telephone Number	:	973-656-6280
Fax Number	:	973-290-7495

Provider Business Practice Location Address
First Line	:	465 UNION AVE
Second Line	:
City	:	BRIDGEWATER
State	:	NJ
Zip	:	08807-3196
Country	:	US
Telephone Number	:	908-864-4820
Fax Number	:	908-864-4819

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/15/2013
Last Update Date	:	07/21/2022

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