Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | 007720 | NY |
NPI | 1609950443 |
---|---|
Provider Name | Dr. Philip J Cilio |
First Address | Merrick, NY 11566-2717 |
Second Address | Merrick, NY 11566-2717 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 25/10/2006 |
Last Update Date | 06/01/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
U69766 | (02) | NY |