Provider Demographics
NPI:1871611087
Name:HILL, LORETTA MERZ (LPN)
Entity type:Individual
Prefix:
First Name:LORETTA
Middle Name:MERZ
Last Name:HILL
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9 ENDERKILL DR
Mailing Address - Street 2:
Mailing Address - City:STAATSBURG
Mailing Address - State:NY
Mailing Address - Zip Code:12580-6009
Mailing Address - Country:US
Mailing Address - Phone:845-889-4367
Mailing Address - Fax:
Practice Address - Street 1:9 ENDERKILL DR
Practice Address - Street 2:
Practice Address - City:STAATSBURG
Practice Address - State:NY
Practice Address - Zip Code:12580-6009
Practice Address - Country:US
Practice Address - Phone:845-889-4367
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-26
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY138635-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02679367Medicaid