Provider Demographics
NPI:1750327953
Name:HILDEBRAND, JUDITH A (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:A
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 PEASLEE HL
Mailing Address - Street 2:
Mailing Address - City:WEST HARTFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06117-2918
Mailing Address - Country:US
Mailing Address - Phone:860-561-2223
Mailing Address - Fax:860-667-6875
Practice Address - Street 1:VETERANS ADMINISTRATION
Practice Address - Street 2:555 WILLARD AVENUE
Practice Address - City:NEWINGTON
Practice Address - State:CT
Practice Address - Zip Code:06111-2600
Practice Address - Country:US
Practice Address - Phone:860-666-6951
Practice Address - Fax:860-667-6875
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT027252174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist