Provider Demographics
NPI:1902894090
Name:HILL, LINDA J (DO)
Entity Type:Individual
Prefix:
First Name:LINDA
Middle Name:J
Last Name:HILL
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:665 SARATOGA RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GANSEVOORT
Mailing Address - State:NY
Mailing Address - Zip Code:12831-1599
Mailing Address - Country:US
Mailing Address - Phone:518-363-8815
Mailing Address - Fax:518-363-8831
Practice Address - Street 1:665 SARATOGA RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GANSEVOORT
Practice Address - State:NY
Practice Address - Zip Code:12831-1599
Practice Address - Country:US
Practice Address - Phone:518-363-8815
Practice Address - Fax:518-363-8831
Is Sole Proprietor?:No
Enumeration Date:2005-10-12
Last Update Date:2017-05-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA232717207Q00000X
VT032-0064779207Q00000X
NY237029207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02694397Medicaid
MA2141957Medicaid
VT1011966Medicaid
NYJ400142345Medicare PIN
NY02694397Medicaid
MA2141957Medicaid