Healthcare Provider Details

I. General information

NPI: 1164525259
Provider Name (Legal Business Name): HILTON EAST ASSISTED LIVING
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/06/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

231 EAST AVE
HILTON NY
14468-1333
US

IV. Provider business mailing address

231 EAST AVE
HILTON NY
14468-1333
US

V. Phone/Fax

Practice location:
  • Phone: 585-392-7171
  • Fax: 585-392-1112
Mailing address:
  • Phone: 585-392-7171
  • Fax: 585-392-1112

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code302F00000X
TaxonomyExclusive Provider Organization
License Number
License Number StateNY

VIII. Authorized Official

Name: ANDREW WEGMAN
Title or Position: ADMINISTRATOR
Credential: B.S.
Phone: 585-392-7171