Provider Demographics
NPI:1558693481
Name:PHELPS MEDICAL SERVICES, PC
Entity Type:Organization
Organization Name:PHELPS MEDICAL SERVICES, PC
Other - Org Name:PHELPS MEDICAL ASSOCIATES, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SHAREHOLDER, DIRECTOR, OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:L
Authorized Official - Last Name:FALTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:914-366-1000
Mailing Address - Street 1:155 WHITE PLAINS RD
Mailing Address - Street 2:SUITE 210A PHELPS PROFESSIONAL BILLING
Mailing Address - City:TARRYTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10591-5523
Mailing Address - Country:US
Mailing Address - Phone:914-269-1762
Mailing Address - Fax:914-524-7985
Practice Address - Street 1:701 N BROADWAY
Practice Address - Street 2:PHELP MEDICAL ASSOCIATES
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591-1020
Practice Address - Country:US
Practice Address - Phone:914-366-1000
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PHELPS MEMORIAL HOSPITAL ASSOCIATION
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2010-02-03
Last Update Date:2013-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No163W00000XNursing Service ProvidersRegistered NurseGroup - Multi-Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty
No207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
No208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)Group - Multi-Specialty