Provider Demographics
NPI:1083484844
Name:HUTCHINSON, LATOYA
Entity Type:Individual
Prefix:MRS
First Name:LATOYA
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 TREADWELL AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10302-1650
Mailing Address - Country:US
Mailing Address - Phone:718-662-4696
Mailing Address - Fax:
Practice Address - Street 1:224 TREADWELL AVE
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10302-1650
Practice Address - Country:US
Practice Address - Phone:718-662-4696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-03
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0000000364SP0813X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes364SP0813XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Geropsychiatric