Provider Demographics
NPI:1649456054
Name:PHILIP, BETTY (PHARM D)
Entity type:Individual
Prefix:MISS
First Name:BETTY
Middle Name:
Last Name:PHILIP
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:910 M ST NW
Mailing Address - Street 2:APT 307
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-6313
Mailing Address - Country:US
Mailing Address - Phone:917-834-8011
Mailing Address - Fax:
Practice Address - Street 1:910 M ST NW
Practice Address - Street 2:APT 307
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-6313
Practice Address - Country:US
Practice Address - Phone:917-834-8011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-01-15
Last Update Date:2010-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY048332183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist