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Individual

DR. GREGORY P PHILLIES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
100 HIGH ST, BUFFALO, NY 14203-1126
(716) 859-2954
(716) 859-2962
Mailing address
PO BOX 1368, WILLIAMSVILLE, NY 14231-1368
(716) 859-2954
(716) 859-2962

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
138862
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00025345105
UNIVERA
01
000525477008
BLUE SHIELD WNY
05
00867092
NY
01
040426002635
FIDELIS
01
1388628W
WORKERS COMPENSATION
NY
01
4195933
GHI
01
5607924
INDEPENDENT HEALTH
01
P00028819
RR MEDICARE
Enumeration date
05/01/2006
Last updated
05/06/2008
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