Provider Demographics
NPI:1194492009
Name:HILL, AVERY RUSHWORTH
Entity type:Individual
Prefix:
First Name:AVERY
Middle Name:RUSHWORTH
Last Name:HILL
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 1:81 DEER RUN DR
Mailing Address - Street 2:
Mailing Address - City:BALLSTON SPA
Mailing Address - State:NY
Mailing Address - Zip Code:12020-4608
Mailing Address - Country:US
Mailing Address - Phone:518-307-0429
Mailing Address - Fax:
Practice Address - Street 1:131 LAWRENCE ST
Practice Address - Street 2:
Practice Address - City:SARATOGA SPRINGS
Practice Address - State:NY
Practice Address - Zip Code:12866-1346
Practice Address - Country:US
Practice Address - Phone:518-587-3600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-27
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist