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General NPI Number Information
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NPI Number | 1316018450
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Entity Type | Individual
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Provider Name | ALEKSANDRA PANOV PHILLIPS M.D.
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Gender | Female
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Dates
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Enumeration Date | 11/12/2006
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Last Update Date | 10/31/2025
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Provider Practice Location Address
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Address Line | 75 MOUNT AUBURN ST
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City | CAMBRIDGE
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State | MA
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Zip | 02138-4960
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Country | US
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Telephone | 508-923-5429
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Fax | 617-495-8078
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Provider Business Mailing Address
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Address Line | 28 SALISBURY ST
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City | TIVERTON
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State | RI
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Zip | 02878-4235
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Country | US
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Telephone | 808-729-4301
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 14781R
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | MD11599
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License Number State | HI
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Taxonomy #3
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 046215
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License Number State | CT
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Taxonomy #4
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 277354
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License Number State | MA
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Taxonomy #5
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 046215
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License Number State | CT
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Taxonomy #6
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD14144
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License Number State | RI
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Taxonomy #7
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Taxonomy Code | 2084P0804X
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Taxonomy Name | Child & Adolescent Psychiatry Physician
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License Number | 14781R
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License Number State | LA
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