Healthcare Provider Details

I. General information

NPI: 1336326776
Provider Name (Legal Business Name): SHANA JOY HILL
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/29/2008
Last Update Date: 01/29/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2516 BELMONT TERRACE 2H
FREDERICKSBURG VA
22401
US

IV. Provider business mailing address

1655 FLATBUSH AVE B403
BROOKLYN NY
11210-3276
US

V. Phone/Fax

Practice location:
  • Phone: 347-729-0957
  • Fax:
Mailing address:
  • Phone: 347-729-0957
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2471S1302X
TaxonomySonography Radiologic Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: