Individual
AUDRA PHILLIPS-ZELEDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
66 AUSTIN BLVD, C, COMMACK, NY 11725-5733
(516) 635-1185
Mailing address
66 AUSTIN BLVD, C, COMMACK, NY 11725-5733
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
025062
NY
Other
Enumeration date
12/09/2013
Last updated
12/09/2013
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