Provider Demographics
NPI:1194543108
Name:HILTS, DENNIS JAMES SR
Entity type:Individual
Prefix:
First Name:DENNIS
Middle Name:JAMES
Last Name:HILTS
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3145 POND HILL RD
Mailing Address - Street 2:
Mailing Address - City:TABERG
Mailing Address - State:NY
Mailing Address - Zip Code:13471-1914
Mailing Address - Country:US
Mailing Address - Phone:315-281-3026
Mailing Address - Fax:
Practice Address - Street 1:3145 POND HILL RD
Practice Address - Street 2:
Practice Address - City:TABERG
Practice Address - State:NY
Practice Address - Zip Code:13471-1914
Practice Address - Country:US
Practice Address - Phone:315-281-3026
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-30
Last Update Date:2024-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY832883940343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)