Individual
DR. KRYSTAL T NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
6533 ROOSEVELT BLVD, PHILADELPHIA, PA 19149
(215) 744-6727
(215) 744-1622
Mailing address
6533 ROOSEVELT BLVD, PHILADELPHIA, PA 19149
(215) 744-6727
(215) 744-1622
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OEG000225
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0181497000
KEYSTONE HLTH PLAN E & PE
—
01
—
1626663
BCBS
PA
01
—
2308658000
KEYSTONE HLTH PLAN E & PE
—
01
—
3548372
AETNA GROUP
PA
01
—
3550323
AETNA IND
—
01
—
D28112
BCBS
—
Enumeration date
06/07/2006
Last updated
03/03/2011
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