Individual
JORDAN HATHORN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
400 BLAKE ST APT 4211, NEW HAVEN, CT 06515-4419
(585) 479-0786
Mailing address
400 BLAKE ST APT 4211, NEW HAVEN, CT 06515-4419
(585) 479-0786
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
7520
CT
Other
Enumeration date
03/02/2026
Last updated
03/02/2026
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