Organization
FUEL MEDICAL LLC
Active
Other names
Fuel Med
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JONATHAN PHILLIPS M.D. (PRESIDENT)
(347) 813-0535
Entity
Organization
Contact information
Practice address
210 MEADOWLANDS PKWY, SECAUCUS, NJ 07094-2311
(347) 813-0535
Mailing address
672 DOGWOOD AVE STE 404, FRANKLIN SQUARE, NY 11010-3247
(347) 813-0535
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
—
—
208VP0014X
Interventional Pain Medicine Physician
—
—
Other
Enumeration date
07/20/2024
Last updated
08/22/2024
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