Individual
AMANDA VUONG THAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
17 MAIN ST, WINTHROP, MA 02152-2715
(617) 569-5800
Mailing address
10 GOVE ST, EAST BOSTON, MA 02128-1920
(617) 569-5800
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN2372507
MA
363LF0000X
Family Nurse Practitioner
Primary
RN2372507
MA
Other
Enumeration date
07/09/2024
Last updated
12/10/2024
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