Individual
MONICA DIEM PHUONG NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
1340 BOYLSTON ST # 6F, BOSTON, MA 02215-4302
(617) 927-6190
(617) 236-4262
Mailing address
12 REVERE PL, MEDFORD, MA 02155-3903
(225) 284-6030
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
5059
MA
Other
Enumeration date
08/03/2012
Last updated
07/26/2021
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