Healthcare Provider Details

I. General information

NPI: 1295700441
Provider Name (Legal Business Name): DR R HILLSMAN MD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2006
Last Update Date: 12/25/2023
Certification Date: 12/25/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 POMPERAUG OFFICE PARK STE 308
SOUTHBURY CT
06488-2293
US

IV. Provider business mailing address

1771 POST RD E
WESTPORT CT
06880-5606
US

V. Phone/Fax

Practice location:
  • Phone: 203-586-1181
  • Fax:
Mailing address:
  • Phone: 203-803-0238
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number021015
License Number StateCT
# 2
Primary TaxonomyN
Taxonomy Code207XX0004X
TaxonomyOrthopaedic Foot and Ankle Surgery Physician
License Number021015
License Number StateCT
# 3
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License Number021015
License Number StateCT

VIII. Authorized Official

Name: DR. REGINA ONIE HILLSMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 203-729-6335