Provider Demographics
NPI:1669122446
Name:HAMPTON, AUSTIN JOHN (PA-C)
Entity type:Individual
Prefix:
First Name:AUSTIN
Middle Name:JOHN
Last Name:HAMPTON
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 E 31ST ST APT 1R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6333
Mailing Address - Country:US
Mailing Address - Phone:315-201-0621
Mailing Address - Fax:
Practice Address - Street 1:222 E 31ST ST APT 1R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6333
Practice Address - Country:US
Practice Address - Phone:315-201-0621
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-25
Last Update Date:2022-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028197363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical