Provider Demographics
NPI:1639158751
Name:HILL, ERICA (DO)
Entity Type:Individual
Prefix:
First Name:ERICA
Middle Name:
Last Name:HILL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:91 MILL ST
Mailing Address - Street 2:SUITE 6
Mailing Address - City:DRACUT
Mailing Address - State:MA
Mailing Address - Zip Code:01826-3276
Mailing Address - Country:US
Mailing Address - Phone:978-957-4750
Mailing Address - Fax:978-957-7177
Practice Address - Street 1:91 MILL ST
Practice Address - Street 2:SUITE 6
Practice Address - City:DRACUT
Practice Address - State:MA
Practice Address - Zip Code:01826-3276
Practice Address - Country:US
Practice Address - Phone:978-957-4750
Practice Address - Fax:978-957-7177
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA4382152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA0323446Medicaid
MAW22052OtherBLUE CROSS/BLUE SHILED
MAM14153Medicare PIN
MA0323446Medicaid