Individual
PHILIP D PANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
355 BARD AVE, STATEN ISLAND, NY 10310-1664
(718) 818-1234
Mailing address
1 SMITH CT, STATEN ISLAND, NY 10314-2819
(917) 842-8189
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
002457-1
NY
Other
Enumeration date
11/29/2011
Last updated
11/29/2011
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