Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2084N0402X | Child Neurologist | 045262 | CT |
Y | 2084N0402X | Child Neurologist | 241292 | NY |
NPI | 1255485645 |
---|---|
Provider Name | Dr. Philip J Overby |
First Address | Poughkeepsie, NY 12601-4723 |
Second Address | Poughkeepsie, NY 12601-4723 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2007 |
Last Update Date | 27/07/2012 |