Provider Demographics
NPI:1194891101
Name:HIDALGO, MARIA DEL CARMEN
Entity type:Individual
Prefix:
First Name:MARIA DEL CARMEN
Middle Name:
Last Name:HIDALGO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 85TH ST
Mailing Address - Street 2:
Mailing Address - City:NORTH BERGEN
Mailing Address - State:NJ
Mailing Address - Zip Code:07047-5141
Mailing Address - Country:US
Mailing Address - Phone:201-982-2954
Mailing Address - Fax:
Practice Address - Street 1:571 ACADEMY ST APT GLE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10034-5105
Practice Address - Country:US
Practice Address - Phone:212-567-0550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2014-01-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY242279207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine