Provider Demographics
NPI:1154460491
Name:DR.HILLI FAMILY PRACTICE AND WELLNESS CENTER
Entity Type:Organization
Organization Name:DR.HILLI FAMILY PRACTICE AND WELLNESS CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:FAMILY PRACTICE
Authorized Official - Prefix:DR
Authorized Official - First Name:RULA
Authorized Official - Middle Name:AHMED
Authorized Official - Last Name:AL-HILLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:856-241-2844
Mailing Address - Street 1:511 BECKETT RD
Mailing Address - Street 2:UNIT 8
Mailing Address - City:SWEDESBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08085-1548
Mailing Address - Country:US
Mailing Address - Phone:856-241-2844
Mailing Address - Fax:856-241-2855
Practice Address - Street 1:511 BECKETT RD
Practice Address - Street 2:UNIT 8
Practice Address - City:SWEDESBORO
Practice Address - State:NJ
Practice Address - Zip Code:08085-1548
Practice Address - Country:US
Practice Address - Phone:856-241-2844
Practice Address - Fax:856-241-2855
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA07651500261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJI04730Medicare UPIN
NJ078318Medicare ID - Type UnspecifiedPROVIDER MEDICARE NUMBER