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NPI Code Detail

MEDICARE: MICHELLE HATHAWAY PA-C

MEDICARE: MICHELLE HATHAWAY PA-C
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
1363AM0700XMedical Physician AssistantTC827KY
2363AM0700XMedical Physician Assistant25MP00320600NJ

General Provider Information

NPI Number : 1558798702
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE HATHAWAY PA-C
Provider Business Mailing Address
First Line : 222 NEW RD STE 201
Second Line :
City : LINWOOD
State : NJ
Zip : 08221-1281
Country : US
Telephone Number : 609-788-8593
Fax Number : 609-904-6929
Provider Business Practice Location Address
First Line : 222 NEW RD STE 201
Second Line :
City : LINWOOD
State : NJ
Zip : 08221-1281
Country : US
Telephone Number : 609-788-8593
Fax Number : 609-904-6929
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/02/2013
Last Update Date : 01/06/2026

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Directions to “ MICHELLE HATHAWAY PA-C” Practice Location

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