1649256165 NPI number — DR. REGINA ONIC HILLSMAN MD

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1649256165 NPI number — DR. REGINA ONIC HILLSMAN MD

Employer Identification Number (EIN):

Provider Organization Name:

Provider Last Name:

HILLSMAN

Provider First Name:

REGINA

Provider Middle Name:

ONIC

Provider Name Prefix Text:

DR.

Provider Name Suffix Text:

Provider Credential Text:

MD

Provider Gender Code:

F

Provider Other Organization Name:

Provider Other Organization Name Type Code:

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:

1649256165

Entity Type Code:

Individual

Replacement NPI:

Last Update Date:

03/07/2023

NPI Deactivation Reason Code:

NPI Deactivation Date:

NPI Reactivation Date:

Provider First Line Business Mailing Address:

1771 POST ROAD EAST

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

Provider Business Mailing Address Country Code:

US

Provider Business Mailing Address Telephone Number:

203-586-1181

Provider Business Mailing Address Fax Number:

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:

12/16/2005

Authorized Official Last Name:

Authorized Official First Name:

Authorized Official Middle Name:

Authorized Official Title or Position:

Authorized Official Telephone Number:

• Taxonomy code: 207XS0114X , with the licence number:  21015 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
• Taxonomy code: 207X00000X , with the licence number: 21015 , registered in the state of CT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

• Identifier: 2108419 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 17903 . This is a "CT CONTROLLED SUBSTANCE" identifier . This identifiers is of the category "OTHER".
• Identifier: 21015 . This is a "CT STATE MEDICAL LICENSE" identifier . This identifiers is of the category "OTHER".
• Identifier: ZS054 . This is a "OXFORD" identifier . This identifiers is of the category "OTHER".
• Identifier: 61399688004 . This is a "ALLIED HEALTH GROUP" identifier . This identifiers is of the category "OTHER".
• Identifier: 045697001/030 . This is a "CIGNA" identifier . This identifiers is of the category "OTHER".
• Identifier: 104857 . This is a "GAB" identifier . This identifiers is of the category "OTHER".
• Identifier: 104857300 . This is a "ACS" identifier . This identifiers is of the category "OTHER".
• Identifier: 010021015CT10 . This is a "ANTHEM BCBS" identifier . This identifiers is of the category "OTHER".
• Identifier: 061399688 004 . This is a "CNC" identifier . This identifiers is of the category "OTHER".
• Identifier: 121822 . This is a "HMC PPO" identifier . This identifiers is of the category "OTHER".
• Identifier: 799988 . This is a "CONNECTICARE" identifier . This identifiers is of the category "OTHER".
• Identifier: 83988 . This is a "UNH" identifier . This identifiers is of the category "OTHER".
• Identifier: OR0504 . This is a "HEALTHNET" identifier . This identifiers is of the category "OTHER".