Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1003186867 |
---|---|
Provider Name | Phi Nguyen I |
First Address | Whitehall, PA 18052-5719 |
Second Address | Whitehall, PA 18052-5719 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/01/2012 |
Last Update Date | 28/01/2022 |