Healthcare Provider Details

I. General information

NPI: 1770557464
Provider Name (Legal Business Name): EVERETT HILL MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 12/22/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

190 ROUTE 31 NORTH SUITE 100
FLEMINGTON NJ
08822-5773
US

IV. Provider business mailing address

190 ROUTE 31 NORTH SUITE 100
FLEMINGTON NJ
08822-5773
US

V. Phone/Fax

Practice location:
  • Phone: 908-788-6654
  • Fax:
Mailing address:
  • Phone: 908-788-6654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMA053499
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: