Healthcare Provider Details

I. General information

NPI: 1568932614
Provider Name (Legal Business Name): MRS. HILARY BAIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HILARY J VON GLAHN CRNA

II. Dates (important events)

Enumeration Date: 12/03/2018
Last Update Date: 05/04/2026
Certification Date: 05/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

99 BEAUVOIR AVE
SUMMIT NJ
07901-3533
US

IV. Provider business mailing address

497 LONG HILL DR
SHORT HILLS NJ
07078-1228
US

V. Phone/Fax

Practice location:
  • Phone: 908-522-2000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number26NJ00870700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: