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General NPI Number Information
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NPI Number | 1003574997
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Entity Type | Individual
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Provider Name | HILLARY A IWEORAH PA-C
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Gender | Male
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Dates
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Enumeration Date | 12/07/2021
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Last Update Date | 09/02/2025
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Provider Practice Location Address
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Address Line | 10 PROGRESS DR STE 2F
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City | SHELTON
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State | CT
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Zip | 06484-6294
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Country | US
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Telephone | 778-443-2548
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Fax | 475-314-3003
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Provider Business Mailing Address
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Address Line | 10 PROGRESS DR STE 2F
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City | SHELTON
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State | CT
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Zip | 06484-6294
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Country | US
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Telephone | 778-443-2548
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Fax | 753-143-0034
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 005343
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License Number State | CT
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