Phillips, Jennifer Dawn

Phillips, Jennifer Dawn is an individual health care provider with primary practice located at 240 Redtail Dr Ste 5&6, Orchard Park NY 14127-0000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Phillips, Jennifer Dawn can be contacted via phone (716) 677-0454.

Contact Information

Primary practice address
240 Redtail Dr Ste 5&6 Orchard Park NY 14127-0000
Phone: (716) 677-0454
Fax: (716) 712-0061
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 007111 New York

Profile Details

NPI number 1659315398
LBN Legal business name Phillips, Jennifer Dawn
Credentials RPA-C
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 15th, 2006
Last updated May 24th, 2021 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1659315398 NPPES
New York MEDICAID 02347079
New York Other 95-11822
New York Other 00026509002
New York Other 000570265003

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