Individual
KENNETH OWEN HILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
110 HO PLAZA, GANNETT HEALTH SERVICES, ITHACA, NY 14853
(607) 255-6106
(607) 254-3503
Mailing address
110 HO PLZ, GANNETT HEALTH SERVICES, ITHACA, NY 14853-3102
(607) 255-6106
(607) 254-3503
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
174503
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01083247
—
NY
01
—
P00450099
RR MEDICARE
NY
Enumeration date
06/14/2006
Last updated
10/03/2016
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