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General NPI Number Information
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NPI Number | 1972407674
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Entity Type | Individual
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Provider Name | HIL JOHN KEVIN TIBALAO JIMENEZ PT, DPT
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Gender | Male
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Dates
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Enumeration Date | 10/06/2026
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Last Update Date | 10/06/2026
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Provider Practice Location Address
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Address Line | 60 HOLMES RD.
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City | MONTICELLO
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State | NY
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Zip | 12701
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Country | US
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Telephone | 845-794-1400
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 266
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City | FERNDALE
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State | NY
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Zip | 12734-0266
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Country | US
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Telephone |
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Fax |
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 045689
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License Number State | NY
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