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NPI Code Detail

MEDICARE: MS. SOPHIA CHERRIL PHILLIPS-CALENDER LPN

MEDICARE:  MS. SOPHIA CHERRIL PHILLIPS-CALENDER  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse307719NY

General Provider Information

NPI Number : 1033487822
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SOPHIA CHERRIL PHILLIPS-CALENDER LPN
Provider Business Mailing Address
First Line : 6 S EVERETT ST
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-2348
Country : US
Telephone Number : 347-249-0406
Fax Number :
Provider Business Practice Location Address
First Line : 6 S EVERETT ST
Second Line :
City : VALLEY STREAM
State : NY
Zip : 11580-2348
Country : US
Telephone Number : 347-249-0406
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/07/2011
Last Update Date : 02/12/2013

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