Individual
BEN PHONG DO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
110 E BROADWAY, FULTON, NY 13069-2300
(315) 598-2380
Mailing address
110 E BROADWAY, FULTON, NY 13069-2300
(716) 507-7130
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
067627
NY
Other
Enumeration date
03/26/2021
Last updated
03/26/2021
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