Provider Demographics
NPI:1427303924
Name:BECKETT-HILL, NICOLE A (MSED)
Entity type:Individual
Prefix:MRS
First Name:NICOLE
Middle Name:A
Last Name:BECKETT-HILL
Suffix:
Gender:F
Credentials:MSED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1003 LYNN DR
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11580-1228
Mailing Address - Country:US
Mailing Address - Phone:516-353-7568
Mailing Address - Fax:
Practice Address - Street 1:1003 LYNN DR
Practice Address - Street 2:
Practice Address - City:VALLEY STREAM
Practice Address - State:NY
Practice Address - Zip Code:11580-1228
Practice Address - Country:US
Practice Address - Phone:516-353-7568
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-20
Last Update Date:2012-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY68302174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist