Individual
PHUONG PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1500 WATERS PL, BRONX, NY 10461-2723
(929) 348-3464
Mailing address
1500 WATERS PL, BRONX, NY 10461-2723
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
Primary
558257-1
NY
Other
Enumeration date
09/23/2019
Last updated
09/23/2019
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