Healthcare Provider Details

I. General information

NPI: 1538431457
Provider Name (Legal Business Name): LAWRENCE HILL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/08/2012
Last Update Date: 02/08/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1801 KUSER RD
TRENTON NJ
08690-3705
US

IV. Provider business mailing address

505 YARROW CIR
DAYTON NJ
08810-2425
US

V. Phone/Fax

Practice location:
  • Phone: 609-585-3925
  • Fax:
Mailing address:
  • Phone: 215-432-7453
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number28RI02272600
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: