Phillips, Paul Matthew

Phillips, Paul Matthew is an sole proprietor health care provider with primary practice located at 10819 Rockaway Blvd , South Ozone Park NY 11420-1034. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Phillips, Paul Matthew can be contacted via phone (718) 845-2620.

Contact Information

Primary practice address
10819 Rockaway Blvd South Ozone Park NY 11420-1034
Phone: (718) 845-2620
Fax: (718) 845-9380
Website:
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Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 081219-1 New York

Profile Details

NPI number 1841632767
LBN Legal business name Phillips, Paul Matthew
Credentials LMSW
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 19th, 2013
Last updated Jul 8th, 2014 - about 12 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 1841632767 NPPES
New York MEDICAID 00078138

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