Healthcare Provider Details

I. General information

NPI: 1649527532
Provider Name (Legal Business Name): HILARY MARKETTA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/09/2012
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46 COOK ST
BROOKLYN NY
11206-4004
US

IV. Provider business mailing address

9218 RANDAL PARK BLVD UNIT 4131
ORLANDO FL
32832-4920
US

V. Phone/Fax

Practice location:
  • Phone: 718-925-2397
  • Fax:
Mailing address:
  • Phone: 407-615-0566
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: