Dr. Phong Cam Ta
Dentist Dentist Anesthesiologist
410 W 53rd St Apt 126
New York
, New York 10019-5622
Dr. Phong Cam Ta
Dentist Dentist Anesthesiologist
410 W 53rd St Apt 126
New York
, New York 10019-5622
(215) 527-8768
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About
Features
Specialties
- Dentist
- Dentist Anesthesiologist
Languages spoken
- English
Location
First Address
- Dr. Phong Cam Ta
- 410 W 53rd St Apt 126
- New York, NY
- Zip : 10019-5693
- Phone : (215) 527-8768
Second Address
- Dr. Phong Cam Ta
- 410 W 53rd St Apt 126
- New York, NY
- Zip : 10019-5622
- Phone : (215) 527-8768
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Is Dr. Phong Cam Ta a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| N | 122300000X | Dentist | P65701 | NY |
| Y | 1223D0004X | Dentist Anesthesiologist | 054360 | NY |
National Provider Identifier
| NPI | 1861646747 |
|---|---|
| Provider Name | Dr. Phong Cam Ta |
| First Address | New York, NY 10019-5693 |
| Second Address | New York, NY 10019-5622 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 05/11/2008 |
| Last Update Date | 16/06/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 03203894 | (05) | NY |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.