Provider Demographics
NPI:1285966697
Name:PHILLIPS, CYNTHIA F (RPH)
Entity type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:F
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4899 E MILESTRIP RD
Mailing Address - Street 2:
Mailing Address - City:CANASTOTA
Mailing Address - State:NY
Mailing Address - Zip Code:13032-4829
Mailing Address - Country:US
Mailing Address - Phone:315-684-9084
Mailing Address - Fax:315-687-1046
Practice Address - Street 1:703 E GENESEE ST
Practice Address - Street 2:
Practice Address - City:CHITTENANGO
Practice Address - State:NY
Practice Address - Zip Code:13037-1329
Practice Address - Country:US
Practice Address - Phone:315-687-6110
Practice Address - Fax:315-687-1046
Is Sole Proprietor?:No
Enumeration Date:2010-02-10
Last Update Date:2010-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY028973-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist