Provider Demographics
NPI:1629175690
Name:HILDRETH, MADELINE J (DC)
Entity Type:Individual
Prefix:DR
First Name:MADELINE
Middle Name:J
Last Name:HILDRETH
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1294
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL JUNCTION
Mailing Address - State:NY
Mailing Address - Zip Code:12533-1294
Mailing Address - Country:US
Mailing Address - Phone:845-452-5200
Mailing Address - Fax:845-483-0824
Practice Address - Street 1:1145 STATE ROUTE 55
Practice Address - Street 2:SUITE 4
Practice Address - City:LAGRANGEVILLE
Practice Address - State:NY
Practice Address - Zip Code:12540-5047
Practice Address - Country:US
Practice Address - Phone:845-452-5200
Practice Address - Fax:845-483-0824
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2013-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY7919111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
X07411Medicare PIN
NYX07411Medicare ID - Type Unspecified