Provider Demographics
NPI:1093474058
Name:PHILO, FREDERICK JOSEPH III
Entity Type:Individual
Prefix:MR
First Name:FREDERICK
Middle Name:JOSEPH
Last Name:PHILO
Suffix:III
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:36 CHAMBERS ST APT 9
Mailing Address - Street 2:
Mailing Address - City:NEWBURGH
Mailing Address - State:NY
Mailing Address - Zip Code:12550-4990
Mailing Address - Country:US
Mailing Address - Phone:845-549-6713
Mailing Address - Fax:
Practice Address - Street 1:36 CHAMBERS ST APT 9
Practice Address - Street 2:
Practice Address - City:NEWBURGH
Practice Address - State:NY
Practice Address - Zip Code:12550-4990
Practice Address - Country:US
Practice Address - Phone:845-549-6713
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-16
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)