Provider Demographics
NPI:1558730457
Name:PHILLIPS, THOMAS PAUL (MSN, APRN, FNP-BC)
Entity Type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:PAUL
Last Name:PHILLIPS
Suffix:
Gender:M
Credentials:MSN, APRN, FNP-BC
Other - Prefix:MR
Other - First Name:THOMAS
Other - Middle Name:PAUL
Other - Last Name:CAPLANDIES
Other - Suffix:III
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 PENN PLZ FL 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10119-0899
Mailing Address - Country:US
Mailing Address - Phone:845-242-6149
Mailing Address - Fax:
Practice Address - Street 1:1 PENN PLZ FL 8
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10119-0899
Practice Address - Country:US
Practice Address - Phone:845-242-6149
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-21
Last Update Date:2021-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLRN9344339163W00000X
FLARNP9344339363LF0000X
NY347622363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse