Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213EP1101X | Primary Podiatric Medicine | 25MD00111400 | NJ |
NPI | 1174584064 |
---|---|
Provider Name | Dr. George Howard Hiller |
First Address | Metuchen, NJ 08840-2442 |
Second Address | Metuchen, NJ 08840-2442 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/03/2006 |
Last Update Date | 03/11/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
T73127 | (02) | NJ |