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Individual
MARY PHAM
Active
Individual
MARY PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
404891
NY
363LA2200X
Adult Health Nurse Practitioner
F332550
NY
363LF0000X
Family Nurse Practitioner
Primary
F301537
NY
Other
Enumeration date
03/29/2007
Last updated
09/11/2025
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