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General NPI Number Information
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NPI Number | 1467724690
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Entity Type | Organization
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Legal Business Name | CAMILLE PHILIPPE M.D., P.C.
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Dates
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Enumeration Date | 02/03/2012
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Last Update Date | 02/03/2012
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Provider Practice Location Address
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Address Line | 8647 164TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-3450
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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 | 8647 164TH ST
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City | JAMAICA
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State | NY
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Zip | 11432-3450
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CAMILLE PHILIPPE
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Credential | M.D.
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Telephone | 718-658-2448
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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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