Individual
GREGORY PHILLIPS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
14309 248TH ST, ROSEDALE, NY 11422-2139
(646) 210-7568
Mailing address
14309 248TH ST, ROSEDALE, NY 11422-2139
(646) 210-7568
Taxonomy
Speciality
Code
Description
License number
State
163WE0003X
Emergency Registered Nurse
615347
NY
363LF0000X
Family Nurse Practitioner
Primary
345053
NY
Other
Enumeration date
06/11/2019
Last updated
09/23/2020
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