Provider Demographics
NPI:1205921483
Name:HUTCHINSON, BETHANY C (NP)
Entity type:Individual
Prefix:
First Name:BETHANY
Middle Name:C
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66 W GILBERT ST
Mailing Address - Street 2:2ND FLOOR
Mailing Address - City:TINTON FALLS
Mailing Address - State:NJ
Mailing Address - Zip Code:07701-4947
Mailing Address - Country:US
Mailing Address - Phone:732-212-0051
Mailing Address - Fax:732-212-0713
Practice Address - Street 1:97 PATERSON ST
Practice Address - Street 2:
Practice Address - City:NEW BRUNSWICK
Practice Address - State:NJ
Practice Address - Zip Code:08901-2160
Practice Address - Country:US
Practice Address - Phone:732-235-6230
Practice Address - Fax:732-235-8766
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJNN087105363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0067491Medicaid
NJ0067491Medicaid
NJ199046C6WMedicare PIN
NJ091670C6WMedicare PIN