Provider Demographics
NPI:1821202250
Name:HASTINGS-SCHMIDT, VICTORIA (PA-C)
Entity type:Individual
Prefix:
First Name:VICTORIA
Middle Name:
Last Name:HASTINGS-SCHMIDT
Suffix:
Gender:F
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 1:1050 MANTUA PIKE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WENONAH
Mailing Address - State:NJ
Mailing Address - Zip Code:08090-1141
Mailing Address - Country:US
Mailing Address - Phone:856-853-0848
Mailing Address - Fax:856-853-1889
Practice Address - Street 1:1050 MANTUA PIKE
Practice Address - Street 2:SUITE 200
Practice Address - City:WENONAH
Practice Address - State:NJ
Practice Address - Zip Code:08090-1141
Practice Address - Country:US
Practice Address - Phone:856-853-0848
Practice Address - Fax:856-853-1889
Is Sole Proprietor?:No
Enumeration Date:2007-05-08
Last Update Date:2013-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00100500363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant