Vaillancourt, Philippe

Vaillancourt, Philippe is an individual health care provider with primary practice located at 712 Main St , Islip NY 11751-3620. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Neurology, Allopathic & Osteopathic Physicians / Pain Medicine. Allopathic & Osteopathic Physicians / Neurology is his primary health care specialty. Vaillancourt, Philippe can be contacted via phone (631) 666-3939.

Contact Information

Primary practice address
712 Main St Islip NY 11751-3620
Phone: (631) 666-3939
Fax: (631) 666-3994
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 139436 New York
Allopathic & Osteopathic Physicians / Pain Medicine 208VP0000X 139436 New York

Profile Details

NPI number 1801861976
LBN Legal business name Vaillancourt, Philippe
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Jun 9th, 2016 - about 8 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 1801861976 NPPES
New York MEDICAID 00976572

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