Provider Demographics
NPI:1689614208
Name:HILL, ALEXANDRA (PT)
Entity Type:Individual
Prefix:
First Name:ALEXANDRA
Middle Name:
Last Name:HILL
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 1:227 S PENDLETON ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29640-3047
Mailing Address - Country:US
Mailing Address - Phone:864-855-7030
Mailing Address - Fax:864-855-7019
Practice Address - Street 1:227 S PENDLETON ST
Practice Address - Street 2:SUITE B
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-3047
Practice Address - Country:US
Practice Address - Phone:864-855-7030
Practice Address - Fax:864-855-7019
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2015-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY025209225100000X
SC6884225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCQ42199Medicare PIN
NYQ10S73Medicare PIN
NYP00331616Medicare PIN
NYRA2796Medicare PIN