Provider Demographics
NPI:1306121322
Name:HILARIO, EDWIN
Entity type:Individual
Prefix:MR
First Name:EDWIN
Middle Name:
Last Name:HILARIO
Suffix:
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 1:114 MAPLE ST
Mailing Address - Street 2:
Mailing Address - City:WEST BOYLSTON
Mailing Address - State:MA
Mailing Address - Zip Code:01583-1825
Mailing Address - Country:US
Mailing Address - Phone:774-253-0220
Mailing Address - Fax:
Practice Address - Street 1:114 MAPLE ST
Practice Address - Street 2:
Practice Address - City:WEST BOYLSTON
Practice Address - State:MA
Practice Address - Zip Code:01583-1825
Practice Address - Country:US
Practice Address - Phone:774-253-0220
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-10-21
Last Update Date:2011-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide