Provider Demographics
NPI:1699311415
Name:HUTCHINSON, STEVEN (OWNER)
Entity type:Individual
Prefix:MR
First Name:STEVEN
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:OWNER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1132 STERLING AVE
Mailing Address - Street 2:
Mailing Address - City:LINWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19061-3918
Mailing Address - Country:US
Mailing Address - Phone:610-955-6508
Mailing Address - Fax:610-485-3414
Practice Address - Street 1:1132 STERLING AVE
Practice Address - Street 2:
Practice Address - City:LINWOOD
Practice Address - State:PA
Practice Address - Zip Code:19061-3918
Practice Address - Country:US
Practice Address - Phone:610-955-6508
Practice Address - Fax:610-485-3414
Is Sole Proprietor?:Yes
Enumeration Date:2019-11-27
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA6814156374700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374700000XNursing Service Related ProvidersTechnicianGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA6814156OtherPA DEPARTMENT OF STATE