Female

Ms. Heather M. Porter PA-C

Physician Assistant in Wall Township, NJ(View on Map)

Full Name

Ms. Heather M Porter PA-C

NPI Number

1588700405

NPI Type

Individual Provider

Gender

Female

Enumeration Date

01/29/2007

Specialties

(Taxonomies)

Code

363A00000X

Primary Taxonomy

Yes

Licenses

State

New Jersey
New York

License Number

25MP00202900
011176

Contact
Information

Purpose

Mailing
Location

Address

539 LOCUST POINT RD
2101 ROUTE 34 STE D

City

Rumson
Wall Township

State

NJ
NJ

Postal Code

07760-2321
07719-9104

Country

US
US

Telephone Number

(732) 204-2780
(732) 974-0003

Provider data last refreshed from NPPES NPI registry on 11/19/2024

Data last updated by provider on 06/15/2010

Provider Address

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