Individual
DR. PHILIP A REMILLARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6700 KIRKVILLE RD, SUITE A, EAST SYRACUSE, NY 13057-9305
(315) 463-2013
(315) 463-2019
Mailing address
6700 KIRKVILLE RD, SUITE A, EAST SYRACUSE, NY 13057-9305
(315) 463-2013
(315) 463-2019
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
191732
—
208000000X
Pediatrics Physician
Primary
191732
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01603869
—
NY
Enumeration date
12/21/2006
Last updated
03/26/2021
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