Provider Demographics
NPI:1508331141
Name:HILL, DESEATRIA (SERVICE COORDINATOR)
Entity Type:Individual
Prefix:
First Name:DESEATRIA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:SERVICE COORDINATOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:22018 HORACE HARDING EXPY
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11364-2227
Mailing Address - Country:US
Mailing Address - Phone:718-423-0056
Mailing Address - Fax:718-229-5370
Practice Address - Street 1:22018 HORACE HARDING EXPY
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11364-2227
Practice Address - Country:US
Practice Address - Phone:718-423-0056
Practice Address - Fax:718-229-5370
Is Sole Proprietor?:No
Enumeration Date:2018-10-10
Last Update Date:2018-10-10
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246QL0901XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, PathologyLaboratory Management, Diplomate