Healthcare Provider Details

I. General information

NPI: 1326432378
Provider Name (Legal Business Name): AMNA M. HILAL
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/26/2015
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1171 E PUTNAM AVE STE 2B
RIVERSIDE CT
06878-1426
US

IV. Provider business mailing address

1171 E PUTNAM AVE STE 2B
RIVERSIDE CT
06878-1426
US

V. Phone/Fax

Practice location:
  • Phone: 203-629-5800
  • Fax:
Mailing address:
  • Phone: 203-629-5800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number76632
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: