Provider Demographics
NPI:1114339645
Name:PHILIPPSBORN, PAMELA (NP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:
Last Name:PHILIPPSBORN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:PAMELA
Other - Middle Name:S
Other - Last Name:PHILIPPSBORN ROSENBACH
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:NP
Mailing Address - Street 1:440 E 81ST ST APT 2C
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-5101
Mailing Address - Country:US
Mailing Address - Phone:908-337-3718
Mailing Address - Fax:
Practice Address - Street 1:10 E 102ND ST FL 5
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6030
Practice Address - Country:US
Practice Address - Phone:212-241-5656
Practice Address - Fax:646-537-9540
Is Sole Proprietor?:No
Enumeration Date:2014-06-02
Last Update Date:2021-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00502000363LA2200X
NY306887363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health