Individual
DR. RANDALL PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2780 MIDDLE COUNTRY RD STE 210, LAKE GROVE, NY 11755-2120
(631) 588-4500
(631) 588-4595
Mailing address
2780 MIDDLE COUNTRY RD STE 210, LAKE GROVE, NY 11755-2120
(631) 588-4500
(631) 588-4595
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
146974
NY
Other
Enumeration date
11/25/2005
Last updated
12/04/2017
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