Provider Demographics
NPI:1558785840
Name:HILL, DAVID (LPN)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 HOLYOKE ST
Mailing Address - Street 2:APT 13
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14615-1933
Mailing Address - Country:US
Mailing Address - Phone:585-309-9737
Mailing Address - Fax:
Practice Address - Street 1:147 HOLYOKE ST
Practice Address - Street 2:APT 13
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14615-1933
Practice Address - Country:US
Practice Address - Phone:585-309-9737
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-07
Last Update Date:2014-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY312397164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse