Provider Demographics
NPI:1861163370
Name:HILL, CLEMENT (PMHNP-BC)
Entity type:Individual
Prefix:MR
First Name:CLEMENT
Middle Name:
Last Name:HILL
Suffix:
Gender:M
Credentials:PMHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:30 CRESCENT AVE
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-5100
Mailing Address - Country:US
Mailing Address - Phone:518-527-1894
Mailing Address - Fax:
Practice Address - Street 1:191 WOOSTER ST
Practice Address - Street 2:
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06511-5736
Practice Address - Country:US
Practice Address - Phone:518-527-1894
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-23
Last Update Date:2022-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY778440163W00000X
NY404426363LP0808X
CT10782363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163W00000XNursing Service ProvidersRegistered Nurse