Provider Demographics
NPI:1275627135
Name:HILLTOP MEDICAL DIAGNOSTIC AND TREATMENT CENTER
Entity Type:Organization
Organization Name:HILLTOP MEDICAL DIAGNOSTIC AND TREATMENT CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATOR/MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:ANDREA
Authorized Official - Middle Name:
Authorized Official - Last Name:TOBIAS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:718-831-1700
Mailing Address - Street 1:25112 HILLSIDE AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEROSE
Mailing Address - State:NY
Mailing Address - Zip Code:11426-2150
Mailing Address - Country:US
Mailing Address - Phone:718-831-1700
Mailing Address - Fax:718-470-6560
Practice Address - Street 1:25112 HILLSIDE AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-2150
Practice Address - Country:US
Practice Address - Phone:718-831-1700
Practice Address - Fax:718-470-6560
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty