Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NS0005X | Chiropractic Sports Physician | X005975 | NY |
NPI | 1326168824 |
---|---|
Provider Name | Dr. Karyn M Phillips |
First Address | New Hyde Park, NY 11040-1399 |
Second Address | New Hyde Park, NY 11040-1399 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
X41421 | (02) | NY |