Healthcare Provider Details

I. General information

NPI: 1871279901
Provider Name (Legal Business Name): HEHIDY PAULINO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/23/2023
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

251 14TH ST
HOBOKEN NJ
07030-3431
US

IV. Provider business mailing address

331 NEWMAN SPRINGS RD BLDG 2, STE 220 ST
RED BANK NJ
07701-5688
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number25MA13266400
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License NumberMT-229009
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: