| Dr Randall Phillips, MD | |
|
2780 Middle Country Rd Ste 210, Lake Grove, NY 11755-2120 | |
| (631) 588-4500 | |
| (631) 588-4595 |
| Full Name | Dr Randall Phillips |
|---|---|
| Gender | Male |
| Speciality | Radiology - Diagnostic Radiology |
| Location | 2780 Middle Country Rd Ste 210, Lake Grove, New York |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1154304962 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2085R0202X | Radiology - Diagnostic Radiology | 146974 (New York) | Primary |
| Entity Name | Medical Arts Radiological Group, Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912096793 PECOS PAC ID: 4789579715 Enrollment ID: O20040218000918 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Randall Phillips, MD 2780 Middle Country Rd Ste 210, Lake Grove, NY 11755-2120 Ph: (631) 588-4500 | Dr Randall Phillips, MD 2780 Middle Country Rd Ste 210, Lake Grove, NY 11755-2120 Ph: (631) 588-4500 |
Alexandra B Perkins, M.D. Radiology Medicare: Accepting Medicare Assignments Practice Location: 2780 Middle Country Rd, Suite 210, Lake Grove, NY 11755 Phone: 631-588-4500 Fax: 631-588-4595 | |
Roberto Antonacci, M.D. Radiology Medicare: Medicare Enrolled Practice Location: 2780 Middle Country Rd, Suite 210, Lake Grove, NY 11755 Phone: 631-588-4500 Fax: 631-588-4595 |