Provider Demographics
NPI:1942224910
Name:HILLMAN, ROY ABRAHAM (MD)
Entity Type:Individual
Prefix:DR
First Name:ROY
Middle Name:ABRAHAM
Last Name:HILLMAN
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 1:200 S BROADWAY STE 106
Mailing Address - Street 2:
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-4504
Mailing Address - Country:US
Mailing Address - Phone:914-366-6821
Mailing Address - Fax:914-366-0641
Practice Address - Street 1:200 S BROADWAY STE 106
Practice Address - Street 2:
Practice Address - City:TARRYTOWN
Practice Address - State:NY
Practice Address - Zip Code:10591-4504
Practice Address - Country:US
Practice Address - Phone:914-366-6821
Practice Address - Fax:914-366-0641
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY189195-1174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01523073Medicaid
NY88K421Medicare ID - Type UnspecifiedMEDICARE
NY01523073Medicaid