Individual
MR. ROBERT E. PHILLIPS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
A.B.O.C.
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
Update your record
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