Healthcare Provider Details

I. General information

NPI: 1851493399
Provider Name (Legal Business Name): JESSE MORTON HILSEN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/04/2006
Last Update Date: 11/18/2024
Certification Date: 11/18/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 NEW KARNER RD
ALBANY NY
12205-4627
US

IV. Provider business mailing address

251 NEW KARNER RD
ALBANY NY
12205-4627
US

V. Phone/Fax

Practice location:
  • Phone: 518-482-9900
  • Fax: 518-288-1282
Mailing address:
  • Phone: 518-482-9900
  • Fax: 518-288-1282

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code202D00000X
TaxonomyIntegrative Medicine Physician
License Number99312
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License Number99312
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number99312
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number99312
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: