# TRANSFORMATIONS PHYSICIANS WEIGHT MANAGEMENT LLC

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Kathleen Hickey, M.D.
- **Organization subpart:** No

## Provider details

- **NPI number:** 1205153251
- **Authorized official:** DR. KATHLEEN ANN HICKEY M.D. (MEDICAL DIRECTOR)
- **Authorized official phone:** (908) 281-6771

## Contact information

- **Practice address:** 719 HIGHWAY 206, SUITE 101, HILLSBOROUGH, NJ 08844-1536
- **Practice address phone:** (908) 281-6771
- **Practice address fax:** (908) 281-6439
- **Mailing address:** 719 HIGHWAY 206, SUITE 101, HILLSBOROUGH, NJ 08844-1536
- **Mailing address phone:** (908) 281-6771
- **Mailing address fax:** (908) 281-6439

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207QB0002X | Obesity Medicine (Family Medicine) Physician | MA067366 | NJ | Yes |
| 363LF0000X | Family Nurse Practitioner | 26NN09992000 | NJ | — |

## Other

- **Enumeration date:** 04/30/2010
- **Last updated:** 05/26/2010

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 016208 | MEDICARE, TYPE UNSPECIFIED | NJ |