Provider Demographics
NPI:1902933617
Name:HILTON, JENNIFER VANDERZEE (DO)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:VANDERZEE
Last Name:HILTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:JENNIFER
Other - Middle Name:VANDERZEE
Other - Last Name:HILTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DO
Mailing Address - Street 1:98 CLEARWATER DR
Mailing Address - Street 2:SUITE ONE
Mailing Address - City:FALMOUTH
Mailing Address - State:ME
Mailing Address - Zip Code:04105-1398
Mailing Address - Country:US
Mailing Address - Phone:207-781-7900
Mailing Address - Fax:207-781-2900
Practice Address - Street 1:98 CLEARWATER DR
Practice Address - Street 2:SUITE ONE
Practice Address - City:FALMOUTH
Practice Address - State:ME
Practice Address - Zip Code:04105-1398
Practice Address - Country:US
Practice Address - Phone:207-781-7900
Practice Address - Fax:207-781-2900
Is Sole Proprietor?:No
Enumeration Date:2007-02-28
Last Update Date:2014-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243157204D00000X
ME2057204D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204D00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine & OMM
Provider Identifiers
StateIdentifier IDID TypeIssuer
MM7302OtherMEDICARE ID - GROUP
MM7302OtherMEDICARE ID - GROUP