Provider Demographics
NPI:1902967011
Name:DIAMOND, HILLARY (MD)
Entity Type:Individual
Prefix:DR
First Name:HILLARY
Middle Name:
Last Name:DIAMOND
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 SEA COVE RD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11768-1850
Mailing Address - Country:US
Mailing Address - Phone:631-300-0585
Mailing Address - Fax:308-888-8554
Practice Address - Street 1:99 SEA COVE RD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:NY
Practice Address - Zip Code:11768-1850
Practice Address - Country:US
Practice Address - Phone:631-300-0585
Practice Address - Fax:308-888-8554
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-12
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY196450207R00000X, 207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
G83317Medicare UPIN
50C661Medicare ID - Type Unspecified