Healthcare Provider Details

I. General information

NPI: 1750375275
Provider Name (Legal Business Name): HILTON O HOSANNAH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/12/2005
Last Update Date: 02/14/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7 SOUTHWOODS BLVD CAPITAL CARDIOLOGY ASSOCIATES PC DIV OF CARDIO SURGERY
ALBANY NY
12211-2526
US

IV. Provider business mailing address

7 SOUTHWOODS BLVD CAPITAL CARDIOLOGY ASSOCIATES PC DIV OF CARDIO SURGERY
ALBANY NY
12211-2526
US

V. Phone/Fax

Practice location:
  • Phone: 518-292-6000
  • Fax: 518-641-6766
Mailing address:
  • Phone: 518-292-6000
  • Fax: 518-641-6766

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number163970
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: