MEDICARE: MRS. CAROLYN HILL CCC-SLP, LIC.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	235Z00000X	Speech-Language Pathologist	001919-1	NY

General Provider Information

NPI Number	:	1093998031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. CAROLYN HILL CCC-SLP, LIC.

Provider Business Mailing Address
First Line	:	1616 MADISON AVE
Second Line	:
City	:	WEST ISLIP
State	:	NY
Zip	:	11795-1725
Country	:	US
Telephone Number	:	631-669-5536
Fax Number	:

Provider Business Practice Location Address
First Line	:	1428 5TH AVE
Second Line	:
City	:	BAY SHORE
State	:	NY
Zip	:	11706-4147
Country	:	US
Telephone Number	:	631-665-1900
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2007
Last Update Date	:	12/13/2007

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Directions to “ MRS. CAROLYN HILL CCC-SLP, LIC.” Practice Location

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