1295700441 NPI number — DR R HILLSMAN MD PC

Table of content: (NPI 1295700441)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1295700441 NPI number — DR R HILLSMAN MD PC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
DR R HILLSMAN MD PC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
DR R HILLSMAN PC
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1295700441
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/25/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1771 POST RD E
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WESTPORT
Provider Business Mailing Address State Name:
CT
Provider Business Mailing Address Postal Code:
06880-5606
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
203-803-0238
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2 POMPERAUG OFFICE PARK STE 308
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SOUTHBURY
Provider Business Practice Location Address State Name:
CT
Provider Business Practice Location Address Postal Code:
06488-2293
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
203-586-1181
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
02/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
HILLSMAN
Authorized Official First Name:
REGINA
Authorized Official Middle Name:
ONIE
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
203-729-6335

Provider Taxonomy Codes

  • Taxonomy code: 207X00000X , with the licence number:  021015 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 207XX0004X , with the licence number: 021015 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207XX0005X , with the licence number: 021015 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 44337 . This is a "MD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: ZS054 . This is a "OXFORD HEALTH PLAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 0R0504 . This is a "PHS" identifier . This identifiers is of the category "OTHER".
  • Identifier: 83988 . This is a "US HEALTHCARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: A89105 . This is a "MEDSPAN" identifier . This identifiers is of the category "OTHER".
  • Identifier: 2108419 . This is a "AETNA" identifier , issued by the state of ( CT ) . This identifiers is of the category "OTHER".
  • Identifier: 200000306 . This is a "RAILROAD MEDICARE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 799988 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com