Provider Demographics
NPI:1285222976
Name:BELL, PHILLIP (FNP)
Entity Type:Individual
Prefix:
First Name:PHILLIP
Middle Name:
Last Name:BELL
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:391 MYRTLE AVE STE 1B
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12208-3835
Mailing Address - Country:US
Mailing Address - Phone:518-264-2225
Mailing Address - Fax:
Practice Address - Street 1:391 MYRTLE AVE # 1B
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12208-3835
Practice Address - Country:US
Practice Address - Phone:518-264-2225
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-01-07
Last Update Date:2022-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY346298363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily