Provider Demographics
NPI:1568602332
Name:HILLER, BETTY (PT)
Entity Type:Individual
Prefix:MRS
First Name:BETTY
Middle Name:
Last Name:HILLER
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2752 LEN DR
Mailing Address - Street 2:
Mailing Address - City:BELLMORE
Mailing Address - State:NY
Mailing Address - Zip Code:11710-5202
Mailing Address - Country:US
Mailing Address - Phone:516-633-0053
Mailing Address - Fax:516-294-8488
Practice Address - Street 1:2752 LEN DR
Practice Address - Street 2:
Practice Address - City:BELLMORE
Practice Address - State:NY
Practice Address - Zip Code:11710-5202
Practice Address - Country:US
Practice Address - Phone:516-633-0053
Practice Address - Fax:516-294-8488
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY015625-12251P0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251P0200XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistPediatrics