Individual
GUILLERMO HIDALGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
19 DAVIS AVE FL 5, NEPTUNE, NJ 07753-4488
(732) 897-3400
(732) 897-3481
Mailing address
3600 ROUTE 66 FL 3, NEPTUNE, NJ 07753-2605
(732) 807-0877
(201) 751-1680
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301084948
MI
2080P0210X
Pediatric Nephrology Physician
036117155
IL
2080P0210X
Pediatric Nephrology Physician
2011-00127
NC
2080P0210X
Pediatric Nephrology Physician
Primary
25MA10679200
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
036117155
MEDICAL LICENSE
IL
01
—
161WY
BCBSNC
NC
05
—
5916951
—
NC
Enumeration date
06/01/2006
Last updated
10/24/2019
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