Provider Demographics
NPI:1386689826
Name:HILLEL, MOSHE (DPM)
Entity Type:Individual
Prefix:
First Name:MOSHE
Middle Name:
Last Name:HILLEL
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1666 FLATBUSH AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11210-3254
Mailing Address - Country:US
Mailing Address - Phone:718-338-7700
Mailing Address - Fax:718-338-7706
Practice Address - Street 1:1666 FLATBUSH AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11210-3254
Practice Address - Country:US
Practice Address - Phone:718-338-7700
Practice Address - Fax:718-338-7706
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-18
Last Update Date:2014-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005965213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02586381Medicaid
NYU99527Medicare UPIN
NYPJ299PDF31Medicare PIN
NYPJ2991Medicare PIN