Individual
MR. ROBERT E. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.B.O.C.
Contact information
Practice address
210 CORNELIA ST, SUITE 302, PLATTSBURGH, NY 12901-2318
(518) 561-8820
(518) 561-2164
Mailing address
210 CORNELIA ST, SUITE 302, PLATTSBURGH, NY 12901-2318
(518) 561-8820
(518) 561-2164
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
006405
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
006405
OPTICIAN LICENSE
NY
05
—
02868142
—
NY
01
—
26671
ABO CERTIFICATION
NY
Enumeration date
05/17/2007
Last updated
07/08/2007
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