Healthcare Provider Details

I. General information

NPI: 1982994109
Provider Name (Legal Business Name): CAROLINE MARY HILLMAN PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2011
Last Update Date: 07/16/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 GODFREY RD E
WESTON CT
06883-1424
US

IV. Provider business mailing address

130 GODFREY RD E
WESTON CT
06883-1424
US

V. Phone/Fax

Practice location:
  • Phone: 203-856-9128
  • Fax:
Mailing address:
  • Phone: 203-856-9128
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code363AS0400X
TaxonomySurgical Physician Assistant
License Number002572
License Number StateCT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: