Individual
AN THU THAI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
7600 CENTRAL AVE, PHILADELPHIA, PA 19111-2442
(215) 728-2169
Mailing address
PO BOX 425, LEDERACH, PA 19450-0425
(800) 528-0006
(732) 349-6030
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA052313
PA
Other
Enumeration date
11/15/2007
Last updated
09/06/2011
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