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Individual

MA LE TRIEU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
OD

Contact information

Practice address
134 KINGSLAND RD STE 3, CLIFTON, NJ 07014-1915
(973) 405-2548
Mailing address
134 KINGSLAND RD STE 3, CLIFTON, NJ 07014-1915
(215) 882-3879

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
27OA00630700
NJ
152W00000X
Optometrist
OEG001868
PA
152W00000X
Optometrist
TUV007689-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0317446
NJ
Enumeration date
02/03/2007
Last updated
05/10/2023
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