Provider Demographics
NPI:1437470853
Name:HILLER, INGRID N (LPN)
Entity type:Individual
Prefix:
First Name:INGRID
Middle Name:N
Last Name:HILLER
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 1:100 SUNFISH LANDING
Mailing Address - Street 2:
Mailing Address - City:MOHEGAN LAKE
Mailing Address - State:NY
Mailing Address - Zip Code:10547
Mailing Address - Country:US
Mailing Address - Phone:914-522-0231
Mailing Address - Fax:
Practice Address - Street 1:100 SUNFISH LANDING
Practice Address - Street 2:
Practice Address - City:MOHEGAN LAKE
Practice Address - State:NY
Practice Address - Zip Code:10547
Practice Address - Country:US
Practice Address - Phone:914-743-1398
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-06-21
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY297717164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse