Healthcare Provider Details

I. General information

NPI: 1336145176
Provider Name (Legal Business Name): PAUL C HILEY MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2005
Last Update Date: 02/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2290 W COUNTY LINE RD
JACKSON NJ
08527-2267
US

IV. Provider business mailing address

2290 W. COUNTY LINE ROAD
JACKSON NJ
08527
US

V. Phone/Fax

Practice location:
  • Phone: 732-364-3881
  • Fax: 732-364-4625
Mailing address:
  • Phone: 732-942-4455
  • Fax: 732-942-4459

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License NumberMA21728
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberMA21728
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: