Individual
JOHN THOMAS PHELAN II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
400 PATROON CREEK BLVD, SUITE 1, ALBANY, NY 12206-5013
(518) 489-0044
(518) 489-3591
Mailing address
400 PATROON CREEK BLVD, SUITE 1, ALBANY, NY 12206-5013
(518) 489-0044
(518) 489-3591
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
214115
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01945188
—
NY
01
—
P01125937
RAILROAD MEDICARE
NY
Enumeration date
05/26/2006
Last updated
03/20/2019
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