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NPI Code Detail

MEDICARE: MRS. MELISSA MARIE PHILLIPS OT

MEDICARE:  MRS. MELISSA MARIE PHILLIPS  OT
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
1225X00000XOccupational Therapist011842-1NY

General Provider Information

NPI Number : 1497991616
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. MELISSA MARIE PHILLIPS OT
Provider Business Mailing Address
First Line : 38 W CHURCH ST
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-2130
Country : US
Telephone Number : 585-421-2000
Fax Number :
Provider Business Practice Location Address
First Line : 38 W CHURCH ST
Second Line :
City : FAIRPORT
State : NY
Zip : 14450-2130
Country : US
Telephone Number : 585-421-2000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2008
Last Update Date : 03/26/2015

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Directions to “ MRS. MELISSA MARIE PHILLIPS OT” Practice Location

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