Individual
STEPHANIE PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
777 E ROUTE 70 # G-101, MARLTON, NJ 08053-2341
(856) 983-9939
(856) 983-9936
Mailing address
777 E ROUTE 70 # G-101, MARLTON, NJ 08053-2341
(856) 983-9939
(856) 983-9936
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
25MP00361800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MP00361800
NJ PHYSICIAN ASSISTANT LICENSE
NJ
Enumeration date
03/10/2015
Last updated
03/10/2015
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