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NPI Code Detail

MEDICARE: VICTORIA HARTLEY PA-C

MEDICARE: VICTORIA HARTLEY 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
1363A00000XPhysician AssistantPA01697RI
2363A00000XPhysician AssistantPA101635MA

General Provider Information

NPI Number : 1689423410
Entity Type Code : Individual
Provider Name (Legal Business Name) : VICTORIA HARTLEY PA-C
Provider Business Mailing Address
First Line : 6 WOODLAKE DR
Second Line :
City : JOHNSTON
State : RI
Zip : 02919-3157
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 1360 W MAIN RD
Second Line :
City : MIDDLETOWN
State : RI
Zip : 02842-6301
Country : US
Telephone Number : 401-606-3110
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2024
Last Update Date : 05/18/2026

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Directions to “ VICTORIA HARTLEY PA-C” Practice Location

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