| Nanette D Phillis, MD, PLLC | |
|
2365 S Clinton Ave Suite 100 Rochester NY 14618-2663 | |
| (585) 461-9500 | |
| (585) 271-1432 |
| Full Name | Nanette D Phillis, MD, PLLC |
|---|---|
| Speciality | Clinic/Center |
| Location | 2365 S Clinton Ave, Rochester, New York |
| Authorized Official Name and Position | Andrew Ophardt (BUSINESS MANAGER) |
| Authorized Official Contact | 5857557878 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Nanette D Phillis, MD, PLLC 2365 S Clinton Ave Suite 100 Rochester NY 14618-2663 Ph: (585) 461-9500 | Nanette D Phillis, MD, PLLC 2365 S Clinton Ave Suite 100 Rochester NY 14618-2663 Ph: (585) 461-9500 |
| NPI Number | 1588832984 |
|---|---|
| Provider Enumeration Date | 02/19/2008 |
| Last Update Date | 02/19/2008 |
| Medicare PECOS PAC ID | 6204858335 |
|---|---|
| Medicare Enrollment ID | O20060103000636 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1588832984 | NPI | - | NPPES |
| 01563840 | Medicaid | NY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 195745 (New York) | Primary |
| Provider Name | Nanette D Phillis |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1225004476 PECOS PAC ID: 1759303886 Enrollment ID: I20060109000172 |
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