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General NPI Number Information
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NPI Number | 1447398490
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Entity Type | Individual
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Provider Name | PHIL FLORENDO M.D.
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Gender | Male
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Dates
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Enumeration Date | 02/02/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 998 CROOKED HILL RD
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City | WEST BRENTWOOD
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State | NY
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Zip | 11717-1043
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Country | US
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Telephone | 631-761-2099
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Fax | 631-761-2129
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Provider Business Mailing Address
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Address Line | 41-42 50TH STREET #4B
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City | WOODSIDE
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State | NY
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Zip | 11377-4332
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Country | US
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Telephone | 212-365-4327
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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 | P54898
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License Number State | NY
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