Healthcare Provider Details

I. General information

NPI: 1104705938
Provider Name (Legal Business Name): PHILANDER TOWNES
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 08/27/2025
Certification Date: 08/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

362 E 148TH ST FL 5
BRONX NY
10455-4005
US

IV. Provider business mailing address

362 E 148TH ST FL 5
BRONX NY
10455-4005
US

V. Phone/Fax

Practice location:
  • Phone: 917-403-4522
  • Fax:
Mailing address:
  • Phone: 718-402-9000
  • Fax: 718-402-9000

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: