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NPI Code Detail

MEDICARE: DR. MARK DAVID HATTON PH.D., M.ED., M.PHIL

MEDICARE: DR. MARK DAVID HATTON PH.D., M.ED., M.PHIL
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
1103T00000XPsychologist35S100297000NJ
2103TA0400XAddiction (Substance Use Disorder) Psychologist35S100297000NJ
3103TC1900XCounseling Psychologist35S100297000NJ
4103TC0700XClinical Psychologist35S100297000NJ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2PS020054OTHERPAPA PSYCHOLOGIST LICENSE
335SI00297000OTHERNJNJ PSYCHOLOGIST LICENSE

General Provider Information

NPI Number : 1831237510
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK DAVID HATTON PH.D., M.ED., M.PHIL
Provider Business Mailing Address
First Line : 280 BEAUMONT DR
Second Line :
City : OXFORD
State : PA
Zip : 19363-1366
Country : US
Telephone Number : 201-638-6203
Fax Number :
Provider Business Practice Location Address
First Line : 300 FRANKLIN TPKE
Second Line :
City : RIDGEWOOD
State : NJ
Zip : 07450-1932
Country : US
Telephone Number : 201-638-6203
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/02/2007
Last Update Date : 05/14/2024

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