Provider Demographics
NPI:1659751576
Name:HILLERY, MICHELE (RD)
Entity Type:Individual
Prefix:MS
First Name:MICHELE
Middle Name:
Last Name:HILLERY
Suffix:
Gender:F
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3745 84TH ST
Mailing Address - Street 2:APT 2
Mailing Address - City:JACKSON HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11372-7255
Mailing Address - Country:US
Mailing Address - Phone:917-834-8007
Mailing Address - Fax:
Practice Address - Street 1:3745 84TH ST
Practice Address - Street 2:APT 2
Practice Address - City:JACKSON HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11372-7255
Practice Address - Country:US
Practice Address - Phone:917-834-8007
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-05
Last Update Date:2015-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered
No133N00000XDietary & Nutritional Service ProvidersNutritionist