Basic Information
| Provider Information | |||||||||
| NPI: | 1831435155 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HILL | ||||||||
| FirstName: | SYRETTA | ||||||||
| MiddleName: | IRENE | ||||||||
| NamePrefix: | MS. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.S, CASAC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 24 GRAND STREET | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125506204 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455627244 | ||||||||
| FaxNumber: | 8452454477 | ||||||||
| Practice Location | |||||||||
| Address1: | PO BOX 2066 | ||||||||
| Address2: | |||||||||
| City: | NEWBURGH | ||||||||
| State: | NY | ||||||||
| PostalCode: | 125500250 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8455627244 | ||||||||
| FaxNumber: | 8452454477 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/13/2012 | ||||||||
| LastUpdateDate: | 11/09/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 11/09/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 104100000X | 091148-1 | NY | Y | Behavioral Health & Social Service Providers | Social Worker |
No ID Information.