Individual
DR. BRADLEY J. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 CLARKSON AVE, SUITE J, BROOKLYN, NY 11203-2056
(718) 270-1714
(718) 270-3233
Mailing address
450 CLARKSON AVE, BOX 1262, BROOKLYN, NY 11203-2056
(718) 270-8867
(718) 270-1794
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
184083-1
NY
207W00000X
Ophthalmology Physician
25MA06584600
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01278495
—
NY
05
—
7384009
—
NJ
Enumeration date
12/02/2005
Last updated
09/26/2007
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