Provider Demographics
NPI:1043857469
Name:HILL, TARA LYNN (MS, RDN, CLC)
Entity type:Individual
Prefix:MS
First Name:TARA
Middle Name:LYNN
Last Name:HILL
Suffix:
Gender:F
Credentials:MS, RDN, CLC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 GLEN LN
Mailing Address - Street 2:
Mailing Address - City:MONTVALE
Mailing Address - State:NJ
Mailing Address - Zip Code:07645-2206
Mailing Address - Country:US
Mailing Address - Phone:201-240-6594
Mailing Address - Fax:
Practice Address - Street 1:2 1ST AVE
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:NY
Practice Address - Zip Code:10962-1106
Practice Address - Country:US
Practice Address - Phone:845-680-4000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-04
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered