MEDICARE: PATRICIA ANN PHILLIP TSHH

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	2355S0801X	Speech-Language Assistant	024503001	NY
2	235Z00000X	Speech-Language Pathologist		NY

General Provider Information

NPI Number	:	1649549544
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ANN PHILLIP TSHH

Provider Business Mailing Address
First Line	:	877 RUTLAND RD APT 3F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1919
Country	:	US
Telephone Number	:	347-350-7929
Fax Number	:

Provider Business Practice Location Address
First Line	:	877 RUTLAND RD APT 3F
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11203-1919
Country	:	US
Telephone Number	:	347-350-7929
Fax Number	:

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

Provider Enumeration Date	:	12/21/2011
Last Update Date	:	07/21/2022

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Directions to “ PATRICIA ANN PHILLIP TSHH” Practice Location

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