Provider Demographics
NPI:1730361064
Name:HILLEY, JOHN P (DC)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:P
Last Name:HILLEY
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 S LIBERTY DR
Mailing Address - Street 2:
Mailing Address - City:STONY POINT
Mailing Address - State:NY
Mailing Address - Zip Code:10980-2337
Mailing Address - Country:US
Mailing Address - Phone:845-429-8989
Mailing Address - Fax:845-429-8989
Practice Address - Street 1:54 S LIBERTY DR
Practice Address - Street 2:
Practice Address - City:STONY POINT
Practice Address - State:NY
Practice Address - Zip Code:10980-2337
Practice Address - Country:US
Practice Address - Phone:845-429-8989
Practice Address - Fax:845-429-8989
Is Sole Proprietor?:No
Enumeration Date:2007-11-28
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYX004653111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYX28541Medicare PIN
NYT41729Medicare UPIN