Provider Demographics
NPI:1861363897
Name:HEDLER, DYLAN ROBERT
Entity type:Individual
Prefix:
First Name:DYLAN
Middle Name:ROBERT
Last Name:HEDLER
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 1:20 STORY CT
Mailing Address - Street 2:
Mailing Address - City:BAYONNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07002-2435
Mailing Address - Country:US
Mailing Address - Phone:201-407-1756
Mailing Address - Fax:
Practice Address - Street 1:49 UNIVERSITY DR # 794
Practice Address - Street 2:
Practice Address - City:CASTLETON
Practice Address - State:VT
Practice Address - Zip Code:05735-4515
Practice Address - Country:US
Practice Address - Phone:201-407-1756
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-15
Last Update Date:2025-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program