Provider Demographics
NPI:1952355984
Name:HILLMONT GI, P.C.
Entity Type:Organization
Organization Name:HILLMONT GI, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:NICOLE
Authorized Official - Middle Name:
Authorized Official - Last Name:BERDECIA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:215-664-4222
Mailing Address - Street 1:1811 BETHLEHEM PIKE
Mailing Address - Street 2:C300
Mailing Address - City:FLOURTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19031
Mailing Address - Country:US
Mailing Address - Phone:215-664-4222
Mailing Address - Fax:215-402-0449
Practice Address - Street 1:1811 BETHLEHEM PIKE # C300
Practice Address - Street 2:
Practice Address - City:FLOURTOWN
Practice Address - State:PA
Practice Address - Zip Code:19031-1111
Practice Address - Country:US
Practice Address - Phone:215-664-4222
Practice Address - Fax:215-402-0449
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:HILLMONT GI, P.C.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2006-05-22
Last Update Date:2014-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207ZC0006XAllopathic & Osteopathic PhysiciansPathologyClinical PathologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA1572610Medicaid
PACC2697OtherRAILROAD
PACC2697OtherRAILROAD
PA810950Medicare PIN