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Individual
MARY T PHELAN
Active
Individual
MARY T PHELAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
F332356-1
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00027329201
UNIVERA
NY
01
—
000560974001
HEALTH NOW
NY
05
—
02699521
—
NY
01
—
161000580
NOVA
NY
01
—
9512998
IHA
NY
Enumeration date
08/03/2006
Last updated
08/24/2018
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