Provider Demographics
NPI:1841631652
Name:PHIPPS, EMMET FRANCIS (FNP)
Entity type:Individual
Prefix:
First Name:EMMET
Middle Name:FRANCIS
Last Name:PHIPPS
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:EMMET
Other - Middle Name:
Other - Last Name:PHIPPS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:1700 ALBEMARLE RD
Mailing Address - Street 2:6K
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-4673
Mailing Address - Country:US
Mailing Address - Phone:646-678-6486
Mailing Address - Fax:
Practice Address - Street 1:53 W 23RD ST FL 6
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-4237
Practice Address - Country:US
Practice Address - Phone:212-746-7200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-09
Last Update Date:2022-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY338188363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily