Individual
KEITH PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
39 WILBUR AVE, NEWARK, NJ 07112-2311
(908) 472-7486
(908) 351-5109
Mailing address
39 WILBUR AVE, NEWARK, NJ 07112-2311
(908) 472-7486
(908) 351-5109
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
Primary
—
—
Other
Enumeration date
03/07/2019
Last updated
03/07/2019
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