Provider Demographics
NPI:1801983358
Name:HAMILTON, JUDITH L (RN, MSN, APN-C)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:L
Last Name:HAMILTON
Suffix:
Gender:F
Credentials:RN, MSN, APN-C
Other - Prefix:
Other - First Name:JUDITH
Other - Middle Name:
Other - Last Name:DICINTIO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5 EVES DR
Mailing Address - Street 2:SUITE 120A
Mailing Address - City:MARLTON
Mailing Address - State:NJ
Mailing Address - Zip Code:08053-3135
Mailing Address - Country:US
Mailing Address - Phone:856-355-0340
Mailing Address - Fax:856-355-0346
Practice Address - Street 1:1000 ATLANTIC AVE
Practice Address - Street 2:
Practice Address - City:CAMDEN
Practice Address - State:NJ
Practice Address - Zip Code:08104-1132
Practice Address - Country:US
Practice Address - Phone:856-246-3542
Practice Address - Fax:856-246-3528
Is Sole Proprietor?:No
Enumeration Date:2006-10-06
Last Update Date:2020-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NN058434363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ26NN058434OtherMEDICAL LICENSE
NJ26NR058434OtherSTATE LICENSE