Provider Demographics
NPI:1801998588
Name:HILL, CYNTHIA MARION (OPTICIAN)
Entity type:Individual
Prefix:MS
First Name:CYNTHIA
Middle Name:MARION
Last Name:HILL
Suffix:
Gender:F
Credentials:OPTICIAN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 PLANDOME RD
Mailing Address - Street 2:
Mailing Address - City:MANHASSET
Mailing Address - State:NY
Mailing Address - Zip Code:11030-2330
Mailing Address - Country:US
Mailing Address - Phone:516-627-5959
Mailing Address - Fax:
Practice Address - Street 1:65 PLANDOME RD
Practice Address - Street 2:
Practice Address - City:MANHASSET
Practice Address - State:NY
Practice Address - Zip Code:11030-2330
Practice Address - Country:US
Practice Address - Phone:516-627-5959
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-02
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005524156FX1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes156FX1800XEye and Vision Services ProvidersTechnician/TechnologistOptician
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005524OtherOPTICIAN LICENSE NUMBER
NY0128570001Medicare NSC