Sovereign Phoenix

Contractor · Great Neck, NY

Organization Active NPI

NPI number 1871909093

Practice location

15 Cuttermill Rd
Great Neck, NY 11021-3252
Phone
(516) 303-0967

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NPI record

NPI
1871909093
Entity type
Organization (Type 2)
Enumeration date
July 8, 2014
Last updated
July 8, 2014
Organization subpart
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
Contractor Primary 171W00000X — —

Authorized official

Name
Tyrone Barnett
Title
Owner
Phone
(516) 303-0967

About Sovereign Phoenix

Sovereign Phoenix is a healthcare organization registered in the NPI registry with the primary taxonomy Contractor (code 171W00000X). The practice location is 15 Cuttermill Rd, Great Neck, NY 11021-3252. The NPI number 1871909093 was assigned on July 8, 2014 and the record was last updated on July 8, 2014.

The authorized official for this organization is Tyrone Barnett, Owner.

Frequently asked questions

What is the NPI number of Sovereign Phoenix?

The NPI number is 1871909093.

What is the phone number of Sovereign Phoenix?

The phone number listed for the practice location is (516) 303-0967.

Where is Sovereign Phoenix located?

15 Cuttermill Rd, Great Neck, NY 11021-3252.

What is the taxonomy code for Sovereign Phoenix?

The primary taxonomy code is 171W00000X – Contractor.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.

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