Provider Demographics
NPI:1407982317
Name:HILLTOP PEDIATRICS PC
Entity Type:Organization
Organization Name:HILLTOP PEDIATRICS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:GEORGE
Authorized Official - Last Name:LON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:908-598-0190
Mailing Address - Street 1:33 OVERLOOK ROAD
Mailing Address - Street 2:SUITE 304
Mailing Address - City:SUMMIT
Mailing Address - State:NJ
Mailing Address - Zip Code:07901-3563
Mailing Address - Country:US
Mailing Address - Phone:908-598-0190
Mailing Address - Fax:908-598-1820
Practice Address - Street 1:33 OVERLOOK ROAD
Practice Address - Street 2:SUITE 304
Practice Address - City:SUMMIT
Practice Address - State:NJ
Practice Address - Zip Code:07901-3563
Practice Address - Country:US
Practice Address - Phone:908-598-0190
Practice Address - Fax:908-598-1820
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-26
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MA048701002080A0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2080A0000XAllopathic & Osteopathic PhysiciansPediatricsAdolescent MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01091547Medicaid
NJE82697Medicare UPIN