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Contact Information

JEDAN PHILLIPS, MD
181 N BELLE MEAD RD
EAST SETAUKET, NY11733-3495
 Phone: 111-111-1111
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Family Medicine

207Q00000X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JEDAN PHILLIPS · (Male)

NPI # 1659317956
Status Active
Credentials MD
Entity Individual
Enumeration date 06/22/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Yes
Identifiers
  • NY License # 226998
  • NY Medicaid 02361939
  • NY Other 7044409 AETNA
  • NY Other 54V391 EMPIRE BC.BS
Hospital affiliation(s)
  • UNIVERSITY HOSPITAL ( STONY BROOK ) - (Acute Care)
    HEALTH SCIENCES CENTER SUNY
    STONY BROOK, NY 11794
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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