Individual
ANDREA M PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
100 N PARK AVE, ROCKVILLE CENTRE, NY 11570-4157
(516) 678-0707
(516) 678-5990
Mailing address
315 NEWPORT RD, UNIONDALE, NY 11553-1627
(516) 761-8162
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
868548
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
174400000X
TEACHER
NY
Enumeration date
05/27/2013
Last updated
05/27/2013
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