Provider Demographics
NPI:1881577328
Name:HUMPHREYS, HUNTER (PA)
Entity type:Individual
Prefix:
First Name:HUNTER
Middle Name:
Last Name:HUMPHREYS
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:272 HAMILTON ST APT 39
Mailing Address - Street 2:
Mailing Address - City:NEW BRUNSWICK
Mailing Address - State:NJ
Mailing Address - Zip Code:08901-2239
Mailing Address - Country:US
Mailing Address - Phone:541-745-8808
Mailing Address - Fax:
Practice Address - Street 1:2 HOSPITAL PLZ RM 101
Practice Address - Street 2:
Practice Address - City:OLD BRIDGE
Practice Address - State:NJ
Practice Address - Zip Code:08857-3152
Practice Address - Country:US
Practice Address - Phone:732-360-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-30
Last Update Date:2025-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MP00952100363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant