Provider Demographics
NPI:1295040616
Name:HOLDEN, HILLARY MARIE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:HILLARY
Middle Name:MARIE
Last Name:HOLDEN
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:100 METROPOLITAN PARK DR STE 100
Mailing Address - Street 2:
Mailing Address - City:LIVERPOOL
Mailing Address - State:NY
Mailing Address - Zip Code:13088-5842
Mailing Address - Country:US
Mailing Address - Phone:315-870-9369
Mailing Address - Fax:
Practice Address - Street 1:2 ELLINWOOD DR
Practice Address - Street 2:
Practice Address - City:NEW HARTFORD
Practice Address - State:NY
Practice Address - Zip Code:13413-1102
Practice Address - Country:US
Practice Address - Phone:315-724-1012
Practice Address - Fax:315-724-5219
Is Sole Proprietor?:No
Enumeration Date:2010-08-10
Last Update Date:2023-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0140991363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant