Active NPI
Lynn P Hillery, MS RD CDN
- Registered Dietitian
- Medford, NY
National Provider Identifier
1295827103
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Dietitian
- License
- 006087-1
- Practice address
- 76 Southaven Ave Ste 2
Medford, NY 11763-3745 - Phone
- (631) 343-2024
- Fax
- (631) 343-2024
- NPI assigned
- Sep 28, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Dietitian | 133V00000X | 006087-1 | NY | Primary |
Addresses
Primary practice location
76 Southaven Ave Ste 2
Medford, NY 11763-3745
Mailing address
25 Andrea LN
West Sayville, NY 11796-1515
Phone (631) 343-2024
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Science
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 006087-1 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1159401600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1275868800000",
"number": "1295827103",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "25 ANDREA LN",
"city": "WEST SAYVILLE",
"state": "NY",
"postal_code": "117961515",
"telephone_number": "631-343-2024",
"fax_number": "631-343-2024"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "76 SOUTHAVEN AVE STE 2",
"city": "MEDFORD",
"state": "NY",
"postal_code": "117633745",
"telephone_number": "631-343-2024",
"fax_number": "631-343-2024"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HILLERY",
"first_name": "LYNN",
"middle_name": "P",
"credential": "MS RD CDN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-09-28",
"last_updated": "2010-06-07",
"status": "A"
},
"taxonomies": [
{
"code": "133V00000X",
"taxonomy_group": "",
"desc": "Dietitian, Registered",
"state": "NY",
"license": "006087-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Medford, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.