Individual
PHILLIP ANDRUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100TH STREET AND MADISON AVENUE, NEW YORK, NY 10029
(212) 241-0101
(212) 426-5083
Mailing address
BOX 1149, ONE GUSTAVE LEVY PLACE, NEW YORK, NY 10029
(212) 241-0101
(212) 426-5083
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2325091
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02567577
—
NY
01
—
P00212232
RR MEDICARE
—
Enumeration date
03/09/2006
Last updated
08/06/2019
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