MEDICARE: ALEXANDRIA FE PHILLIPS

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	1041C0700X	Clinical Social Worker	093189	NY

General Provider Information

NPI Number	:	1275232563
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ALEXANDRIA FE PHILLIPS

Provider Business Mailing Address
First Line	:	68 FLOWER HILL RD
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2343
Country	:	US
Telephone Number	:	516-305-1813
Fax Number	:

Provider Business Practice Location Address
First Line	:	68 FLOWER HILL RD
Second Line	:
City	:	HUNTINGTON
State	:	NY
Zip	:	11743-2343
Country	:	US
Telephone Number	:	516-305-1813
Fax Number	:

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

Provider Enumeration Date	:	02/27/2023
Last Update Date	:	02/27/2023

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