Doctor Name: | MR. JOHN JOSEPH PHILLIPS |
NPI Number: | 1376820563 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS-CCC-SLP |
License Number: | 005836-1 |
Business Practice Address: | 84 Nightengale Ave Massena, NY - 136622538 |
Business Phone Number: | 3157643700 |
Business Fax Number: | |
Mailing Address: | 67 Highland Ave, MASSENA |
State: | NY |
Postal Code: | 136621772 |
Phone Number: | 3157649811 |
Fax Number: | |
NPI Enumeration Date: | 11/16/2011 |
NPI Last Update Date: | 01/18/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 235Z00000X |
License Number: | 005836-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Speech, Language and Hearing Service Providers |
Taxonomy Classification: | Speech-Language Pathologist |
Taxonomy Specialization: | |
Taxonomy Definition: | A speech pathologist is a person qualified by a master |