Provider Demographics
NPI:1366637787
Name:EMILIA PHILLIPS MD PC
Entity Type:Organization
Organization Name:EMILIA PHILLIPS MD PC
Other - Org Name:UROLOGY CENTER FOR WOMEN
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EMILIA
Authorized Official - Middle Name:
Authorized Official - Last Name:PHILLIPS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:716-834-5517
Mailing Address - Street 1:3140 SHERIDAN DR
Mailing Address - Street 2:SUITE 219
Mailing Address - City:AMHERST
Mailing Address - State:NY
Mailing Address - Zip Code:14226-1900
Mailing Address - Country:US
Mailing Address - Phone:716-834-5517
Mailing Address - Fax:716-834-5514
Practice Address - Street 1:3140 SHERIDAN DR
Practice Address - Street 2:SUITE 219
Practice Address - City:AMHERST
Practice Address - State:NY
Practice Address - Zip Code:14226-1900
Practice Address - Country:US
Practice Address - Phone:716-834-5517
Practice Address - Fax:716-834-5514
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2013-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208800000XAllopathic & Osteopathic PhysiciansUrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYF52958Medicare UPIN