Provider Demographics
NPI:1154390151
Name:PHILIP T. DREW, MD
Entity type:Organization
Organization Name:PHILIP T. DREW, MD
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:C
Authorized Official - Last Name:COOKE
Authorized Official - Suffix:
Authorized Official - Credentials:CMPE
Authorized Official - Phone:518-439-8555
Mailing Address - Street 1:1345 NEW SCOTLAND RD
Mailing Address - Street 2:
Mailing Address - City:SLINGERLANDS
Mailing Address - State:NY
Mailing Address - Zip Code:12159-7216
Mailing Address - Country:US
Mailing Address - Phone:518-439-8555
Mailing Address - Fax:518-439-8145
Practice Address - Street 1:1345 NEW SCOTLAND RD
Practice Address - Street 2:
Practice Address - City:SLINGERLANDS
Practice Address - State:NY
Practice Address - Zip Code:12159-7216
Practice Address - Country:US
Practice Address - Phone:518-439-8555
Practice Address - Fax:518-439-8145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-14
Last Update Date:2007-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty