Healthcare Provider Details

I. General information

NPI: 1407982317
Provider Name (Legal Business Name): HILLTOP PEDIATRICS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/26/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 OVERLOOK ROAD SUITE 304
SUMMIT NJ
07901-3563
US

IV. Provider business mailing address

33 OVERLOOK ROAD SUITE 304
SUMMIT NJ
07901-3563
US

V. Phone/Fax

Practice location:
  • Phone: 908-598-0190
  • Fax: 908-598-1820
Mailing address:
  • Phone: 908-598-0190
  • Fax: 908-598-1820

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number25MA04870100
License Number StateNJ

VIII. Authorized Official

Name: DR. RICHARD GEORGE LON
Title or Position: PRESIDENT
Credential: MD
Phone: 908-598-0190