Provider Demographics
NPI:1720302722
Name:HILAIRE, GERARD (MD)
Entity Type:Individual
Prefix:DR
First Name:GERARD
Middle Name:
Last Name:HILAIRE
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 1:1499 FRANCIS AVE
Mailing Address - Street 2:
Mailing Address - City:NORTH BALDWIN
Mailing Address - State:NY
Mailing Address - Zip Code:11510-1638
Mailing Address - Country:US
Mailing Address - Phone:516-526-2618
Mailing Address - Fax:
Practice Address - Street 1:44 BEAVER ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10004-2431
Practice Address - Country:US
Practice Address - Phone:917-237-5899
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-03-18
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY118615172V00000X, 173000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes173000000XOther Service ProvidersLegal MedicineGroup - Single Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty