Individual
PHALA HOEUN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPO
Contact information
Practice address
130 W KINGSBRIDGE RD DEPT 3E-15, BRONX, NY 10468-3904
(718) 584-9000
Mailing address
8240 AUSTIN ST APT 2K, KEW GARDENS, NY 11415-1416
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
CPO03567
DE
Other
Enumeration date
06/01/2021
Last updated
06/01/2021
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