NPI 1104961713 · live from the CMS NPI Registry
Phyllis Altadonna, RPA-C
Physician Assistant in New York, NY. National Provider Identifier 1104961713, active.
NPI record
| NPI | 1104961713 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Physician Assistant 363A00000X |
| Practice location | 5141 Broadway, New York, NY 10034 |
| Practice phone | 212-932-5218 |
| Mailing address | 1055 River Rd, Apt 802, Edgewater, NJ 07020 |
| Enumerated | February 21, 2007 |
| Last updated | July 8, 2007 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Physician Assistant primary | 363A00000X | 009880-1 (NY) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.