MEDICARE: CELESTE M PHILLIPS NP

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
1	363LA2200X	Adult Health Nurse Practitioner	302215-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215932546
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CELESTE M PHILLIPS NP

Provider Business Mailing Address
First Line	:	2365 CLINTON AVE S
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-442-5320
Fax Number	:	585-442-5526

Provider Business Practice Location Address
First Line	:	2365 CLINTON AVE S
Second Line	:	SUITE 100
City	:	ROCHESTER
State	:	NY
Zip	:	14618-2663
Country	:	US
Telephone Number	:	585-442-5320
Fax Number	:	585-442-5526

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/14/2005
Last Update Date	:	01/04/2023

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