Individual
MICHAEL PHILIP PHYTIDES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
328 W SAINT GEORGES AVE, LINDEN, NJ 07036-5638
(908) 925-7519
Mailing address
130 FIGUREA AVE, STATEN ISLAND, NY 10312-3239
(718) 984-1806
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
021519-1
NY
Other
Enumeration date
11/08/2017
Last updated
12/11/2019
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