Individual
MICHAEL HAWTHORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
80 5TH AVE, NEW YORK, NY 10011-8002
(347) 707-7735
Mailing address
664 E 220TH ST, BRONX, NY 10467-5318
(914) 294-2762
(332) 273-7595
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN168720
GA
363LA2200X
Adult Health Nurse Practitioner
F308186
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
404654
NY
Other
Enumeration date
10/05/2017
Last updated
07/28/2025
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