Kristina Philippen

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

License

801182131 Issued in NY

Practice address

538 Broadhollow Rd
Suite 202
Melville, NY 11747-3676

Phone

(631) 385-7780

NPI assigned

Mar 18, 2015

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1426636800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426636800000",
    "number": "1679967418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 COMMONWEALTH AVE",
            "city": "MASSAPEQUA",
            "state": "NY",
            "postal_code": "117584142",
            "telephone_number": "516-451-0771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "538 BROADHOLLOW RD",
            "address_2": "SUITE 202",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117473676",
            "telephone_number": "631-385-7780"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILIPPEN",
        "first_name": "KRISTINA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-18",
        "last_updated": "2015-03-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "251C00000X",
            "taxonomy_group": "",
            "desc": "Day Training, Developmentally Disabled Services",
            "state": "NY",
            "license": "801263131",
            "primary": false
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": "801182131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laurel Pettit, DPT
• Maurice L Pettway Jr.
• Cheyenne A Peyton
• Phaxis Health Solutions LLC
• Kemuel Philippe
• Paulette Phillippe, LMT
• Autumn Marie Phillips
• Donna Phillips, RN
• Kathleen Phillips, MA
• Thomas Michael Pica, MSW, LCSW, CASAC 2

• Early Intervention Provider Agency in Melville, NY
• Providers in Melville, NY by specialty
• Early Intervention Provider Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.