Provider Demographics
NPI:1780164863
Name:HOOKER, TALORE A (PA-C)
Entity type:Individual
Prefix:
First Name:TALORE
Middle Name:A
Last Name:HOOKER
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 1:134 BRIDGETON PIKE STE C
Mailing Address - Street 2:
Mailing Address - City:MULLICA HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08062-2616
Mailing Address - Country:US
Mailing Address - Phone:856-507-2783
Mailing Address - Fax:856-221-4138
Practice Address - Street 1:698 MULLICA HILL RD STE 320
Practice Address - Street 2:
Practice Address - City:MULLICA HILL
Practice Address - State:NJ
Practice Address - Zip Code:08062-4453
Practice Address - Country:US
Practice Address - Phone:856-507-2783
Practice Address - Fax:856-221-4138
Is Sole Proprietor?:No
Enumeration Date:2018-08-17
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA060034363A00000X
NJ25MP00871100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant