Individual
MRS. SUSAN LEE PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
6 JODI CT, GLEN COVE, NY 11542-1479
(516) 674-8361
(516) 674-8361
Mailing address
6 JODI CT, GLEN COVE, NY 11542-1479
(516) 674-8361
(516) 674-8361
Taxonomy
Speciality
Code
Description
License number
State
133VN1004X
Pediatric Nutrition Registered Dietitian
Primary
1558-1
NY
Other
Enumeration date
11/18/2008
Last updated
11/18/2008
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