Provider Demographics
NPI:1881810117
Name:ROCKHILL, VICKI L
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:L
Last Name:ROCKHILL
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:347 ELM ST
Mailing Address - Street 2:PO BOX 607
Mailing Address - City:MALONE
Mailing Address - State:NY
Mailing Address - Zip Code:12953-1500
Mailing Address - Country:US
Mailing Address - Phone:518-483-6650
Mailing Address - Fax:518-483-4440
Practice Address - Street 1:347 ELM ST
Practice Address - Street 2:
Practice Address - City:MALONE
Practice Address - State:NY
Practice Address - Zip Code:12953-1500
Practice Address - Country:US
Practice Address - Phone:518-483-6650
Practice Address - Fax:518-483-4440
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-17
Last Update Date:2019-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0734146L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes146L00000XEmergency Medical Service ProvidersEmergency Medical Technician, Paramedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
P00101957OtherPALMETTO GBA RAILROAD MEDICARE
NY02631950Medicaid
P00101957OtherPALMETTO GBA RAILROAD MEDICARE