Provider Demographics
NPI:1194164327
Name:THILL, ZOEY
Entity type:Individual
Prefix:
First Name:ZOEY
Middle Name:
Last Name:THILL
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 1:3215 HULL AVE
Mailing Address - Street 2:APT 2D
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10467-4321
Mailing Address - Country:US
Mailing Address - Phone:586-855-0811
Mailing Address - Fax:
Practice Address - Street 1:111 E 210TH ST
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2401
Practice Address - Country:US
Practice Address - Phone:718-920-2625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-06-20
Last Update Date:2013-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program