Provider Demographics
NPI:1235457185
Name:HILL, MAL (PHD)
Entity Type:Individual
Prefix:DR
First Name:MAL
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 TWIN OAK RD
Mailing Address - Street 2:
Mailing Address - City:SOUTH ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07079-1219
Mailing Address - Country:US
Mailing Address - Phone:862-205-1129
Mailing Address - Fax:973-761-0049
Practice Address - Street 1:441 TWIN OAK RD
Practice Address - Street 2:
Practice Address - City:SOUTH ORANGE
Practice Address - State:NJ
Practice Address - Zip Code:07079-1219
Practice Address - Country:US
Practice Address - Phone:862-205-1129
Practice Address - Fax:973-761-0049
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-16
Last Update Date:2012-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education