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General NPI Number Information
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NPI Number | 1063637361
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Entity Type | Organization
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Legal Business Name | CAMILLE PHILIPPE MD, PC
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Dates
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Enumeration Date | 04/13/2007
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Last Update Date | 05/16/2008
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Provider Practice Location Address
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Address Line | 16405 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4140
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Country | US
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Telephone | 718-658-2448
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Fax | 718-658-2603
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Provider Business Mailing Address
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Address Line | 16405 HILLSIDE AVE
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City | JAMAICA
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State | NY
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Zip | 11432-4140
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Country | US
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Telephone | 718-658-2448
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Fax | 718-658-2603
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Authorized Official
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Title or Position | PRACTICE COORDINATOR
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Name | MR. RICHARD SANCIO
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Credential |
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Telephone | 718-725-7031
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 147143
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License Number State | NY
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