Basic Information
Provider Information
NPI: 1437229630
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HILL
FirstName: MICHAEL
MiddleName: J
NamePrefix:  
NameSuffix:  
Credential: RNP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 301 E 21ST ST
Address2: APT. 5F
City: NEW YORK
State: NY
PostalCode: 100106543
CountryCode: US
TelephoneNumber: 7185792500
FaxNumber: 7185792599
Practice Location
Address1: MMG - CHCC
Address2: 305 EAST 161ST STREET
City: BRONX
State: NY
PostalCode: 10451
CountryCode: US
TelephoneNumber: 7185792500
FaxNumber:  
Other Information
ProviderEnumerationDate: 11/08/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
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AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
363L00000XF333267NYY Physician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner 

No ID Information.


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