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Individual

DR. DENNIS-ROGER PHILLIP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
270 PARK AVE, HUNTINGTON, NY 11743-2787
(631) 547-6392
Mailing address
PO BOX 33682, HARTFORD, CT 06150-3682
(631) 547-6392

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
232970
NY
208C00000X
Colon & Rectal Surgery Physician
232970
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
02581877
NY
Enumeration date
03/17/2006
Last updated
12/02/2021
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