MEDICARE: MS. MICHELLE SHAWN HILL

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	208100000X	Physical Medicine & Rehabilitation Physician	002501-01	NY
2	225200000X	Physical Therapy Assistant	002501-01	NY

General Provider Information

NPI Number	:	1346024957
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. MICHELLE SHAWN HILL

Provider Business Mailing Address
First Line	:	2261 HAMPDEN PL APT 2
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5506
Country	:	US
Telephone Number	:	646-708-4755
Fax Number	:

Provider Business Practice Location Address
First Line	:	2261 HAMPDEN PL APT 2
Second Line	:
City	:	BRONX
State	:	NY
Zip	:	10468-5506
Country	:	US
Telephone Number	:	646-708-4755
Fax Number	:

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

Provider Enumeration Date	:	08/23/2023
Last Update Date	:	08/23/2023

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