Provider Demographics
NPI:1962428565
Name:LAWTON, MICHELE WOODWARD (PA-C)
Entity type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:WOODWARD
Last Name:LAWTON
Suffix:
Gender:F
Credentials:PA-C
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Mailing Address - Street 1:258 RUTGERS PL
Mailing Address - Street 2:
Mailing Address - City:NUTLEY
Mailing Address - State:NJ
Mailing Address - Zip Code:07110-1838
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:475 SEAVIEW AVE
Practice Address - Street 2:OB / GYN DEPARTMENT
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10305-3436
Practice Address - Country:US
Practice Address - Phone:715-226-9269
Practice Address - Fax:718-226-6873
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-15
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY005361-1363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant