Provider Demographics
NPI:1821136052
Name:HEATH-PHILLIP, ONECA SJ (MD)
Entity Type:Individual
Prefix:
First Name:ONECA
Middle Name:SJ
Last Name:HEATH-PHILLIP
Suffix:
Gender:F
Credentials:MD
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Other - Credentials:
Mailing Address - Street 1:441 9TH AVE
Mailing Address - Street 2:ACP-CREDENTIALING
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10001-1623
Mailing Address - Country:US
Mailing Address - Phone:646-680-2894
Mailing Address - Fax:516-542-5556
Practice Address - Street 1:2832 LINDEN BLVD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11208-5132
Practice Address - Country:US
Practice Address - Phone:718-240-2000
Practice Address - Fax:718-240-2260
Is Sole Proprietor?:No
Enumeration Date:2007-02-01
Last Update Date:2015-11-17
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NY203383207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY2088264Medicaid
NY2088264Medicaid
NY472801Medicare ID - Type Unspecified