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General NPI Number Information
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NPI Number | 1710281845
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Entity Type | Individual
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Provider Name | ELEANORA ANGELA PHILLIPS-BURDGE
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Gender | Female
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Dates
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Enumeration Date | 01/04/2011
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Last Update Date | 11/15/2024
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Provider Practice Location Address
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Address Line | 116 WOOD RD
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City | FREEVILLE
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State | NY
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Zip | 13068-9752
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Country | US
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Telephone | 607-708-1110
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Fax | 607-708-1130
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Provider Business Mailing Address
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Address Line | 116 WOOD RD
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City | FREEVILLE
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State | NY
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Zip | 13068-9752
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Country | US
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Telephone | 607-708-1110
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Fax | 607-708-1130
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 033359
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License Number State | NY
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