Provider Demographics
NPI:1508945650
Name:MUSKIN, PHILIP R (MD)
Entity Type:Individual
Prefix:DR
First Name:PHILIP
Middle Name:R
Last Name:MUSKIN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 YORK AVE APT 1L
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-7815
Mailing Address - Country:US
Mailing Address - Phone:212-722-8438
Mailing Address - Fax:212-342-1115
Practice Address - Street 1:1700 YORK AVE APT 1L
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10128-7815
Practice Address - Country:US
Practice Address - Phone:212-722-8438
Practice Address - Fax:212-342-1115
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-02
Last Update Date:2016-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1241582084P0805X, 2084P0800X, 2084P0015X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry
No2084P0015XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychosomatic Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00581911Medicaid
NYB13415Medicare UPIN
NY00581911Medicaid