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Individual

DR. LY THIEN NGO

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
909 WALNUT STREET, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-1234
(215) 923-6792
Mailing address
909 WALNUT STREET, 2ND FLOOR, PHILADELPHIA, PA 19107-5509
(215) 955-1234
(215) 923-6792

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
25MA09265000
NJ
2084N0400X
Neurology Physician
Primary
MD445016
PA

Other

Enumeration date
06/22/2008
Last updated
12/15/2014
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