Provider Demographics
NPI:1801141064
Name:HILDENBRAND SCLAFANI, KELLY AMANDA
Entity type:Individual
Prefix:MRS
First Name:KELLY
Middle Name:AMANDA
Last Name:HILDENBRAND SCLAFANI
Suffix:
Gender:F
Credentials:
Other - Prefix:MISS
Other - First Name:KELLY
Other - Middle Name:AMANDA
Other - Last Name:HILDENBRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:41 PINE ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-2206
Mailing Address - Country:US
Mailing Address - Phone:631-766-3737
Mailing Address - Fax:
Practice Address - Street 1:4714 GETTYSBURG RD
Practice Address - Street 2:
Practice Address - City:MECHANICSBURG
Practice Address - State:PA
Practice Address - Zip Code:17055-4325
Practice Address - Country:US
Practice Address - Phone:717-972-1100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-13
Last Update Date:2012-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist