Provider Demographics
NPI:1841429206
Name:HAMILTON, HEATHER K (MD)
Entity Type:Individual
Prefix:DR
First Name:HEATHER
Middle Name:K
Last Name:HAMILTON
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 1:57 N MIDDLETOWN RD
Mailing Address - Street 2:
Mailing Address - City:NANUET
Mailing Address - State:NY
Mailing Address - Zip Code:10954-2312
Mailing Address - Country:US
Mailing Address - Phone:845-623-7077
Mailing Address - Fax:
Practice Address - Street 1:4 CORPORATE DR STE 386
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6240
Practice Address - Country:US
Practice Address - Phone:203-538-5682
Practice Address - Fax:203-538-5685
Is Sole Proprietor?:No
Enumeration Date:2009-07-07
Last Update Date:2018-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS94-07195207N00000X
CT055128207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology