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MISS PATRICIA PHIPPS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNA

Contact information

Practice address
1650 GRAND CONCOURSE, BRONX, NY 10457-7606
(718) 466-8153
(718) 228-7471
Mailing address
11781 LEE JACKSON MEMORIAL HWY, STE 550, FAIRFAX, VA 22033-3309
(571) 777-5164
(703) 890-2650

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
051701
NY
367500000X
Certified Registered Nurse Anesthetist
Primary
310437
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
051701
LICENSE #
NY
01
A40001202
MC PTAN
NY
Enumeration date
10/10/2006
Last updated
10/06/2015
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