Provider Demographics
NPI:1760447197
Name:HANCHUK, HILARY THEODORE (MD)
Entity Type:Individual
Prefix:DR
First Name:HILARY
Middle Name:THEODORE
Last Name:HANCHUK
Suffix:
Gender:M
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:PO BOX 187
Mailing Address - Street 2:
Mailing Address - City:PEAPACK
Mailing Address - State:NJ
Mailing Address - Zip Code:07977-0187
Mailing Address - Country:US
Mailing Address - Phone:908-781-6242
Mailing Address - Fax:908-781-6242
Practice Address - Street 1:764 EASTON AVE
Practice Address - Street 2:STE 6
Practice Address - City:SOMERSET
Practice Address - State:NJ
Practice Address - Zip Code:08873-1856
Practice Address - Country:US
Practice Address - Phone:908-781-6242
Practice Address - Fax:908-782-6242
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-19
Last Update Date:2014-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJMA05467902084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ0423602Medicaid
NJ606934C2EOtherMEDICARE BILLING NO.
NJ606934C2EOtherMEDICARE BILLING NO.
NJ0423602Medicaid