Provider Demographics
NPI:1053132639
Name:BADER, JAMIE (PA-C)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:
Last Name:BADER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23 CROSLEY TER
Mailing Address - Street 2:
Mailing Address - City:HILLSDALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07642-2859
Mailing Address - Country:US
Mailing Address - Phone:201-994-6368
Mailing Address - Fax:
Practice Address - Street 1:23 CROSLEY TER
Practice Address - Street 2:
Practice Address - City:HILLSDALE
Practice Address - State:NJ
Practice Address - Zip Code:07642-2859
Practice Address - Country:US
Practice Address - Phone:201-994-6368
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-17
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical