Provider Demographics
NPI:1174772735
Name:CHEETHAM, PHILIPPA JAYNE (MBCHB (HONS) MD MRCS)
Entity type:Individual
Prefix:DR
First Name:PHILIPPA
Middle Name:JAYNE
Last Name:CHEETHAM
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Gender:F
Credentials:MBCHB (HONS) MD MRCS
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Mailing Address - Street 1:200 OLD COUNTRY RD
Mailing Address - Street 2:SUITE 520
Mailing Address - City:MINEOLA
Mailing Address - State:NY
Mailing Address - Zip Code:11501-4235
Mailing Address - Country:US
Mailing Address - Phone:646-216-7979
Mailing Address - Fax:516-216-7978
Practice Address - Street 1:8002 KEW GARDENS RD
Practice Address - Street 2:SUITE 323
Practice Address - City:KEW GARDENS
Practice Address - State:NY
Practice Address - Zip Code:11415-3600
Practice Address - Country:US
Practice Address - Phone:646-216-7979
Practice Address - Fax:646-216-7978
Is Sole Proprietor?:No
Enumeration Date:2008-09-18
Last Update Date:2015-06-15
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Provider Licenses
StateLicense IDTaxonomies
NY267290208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology