Provider Demographics
NPI:1548451461
Name:HILDEBRAND, PATRICIA A (PTA)
Entity type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:A
Last Name:HILDEBRAND
Suffix:
Gender:F
Credentials:PTA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 OAKLYN TER
Mailing Address - Street 2:
Mailing Address - City:PITTSGROVE
Mailing Address - State:NJ
Mailing Address - Zip Code:08318-3834
Mailing Address - Country:US
Mailing Address - Phone:856-358-7528
Mailing Address - Fax:
Practice Address - Street 1:17 OAKLYN TER
Practice Address - Street 2:
Practice Address - City:PITTSGROVE
Practice Address - State:NJ
Practice Address - Zip Code:08318-3834
Practice Address - Country:US
Practice Address - Phone:856-358-7528
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-06
Last Update Date:2007-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ40QB00229100225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant