Individual
LIEU PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
700 TOWN BANK RD, NORTH CAPE MAY, NJ 08204-4411
(609) 898-8899
Mailing address
31 EQUESTRIAN RD, EGG HARBOR TOWNSHIP, NJ 08234-8006
(609) 829-3024
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
26NJ00609800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
26NJ00609800
ADVANCE NURSE PRACTITIONER
NJ
01
—
26NR15527300
REGISTERED NURSE
NJ
Enumeration date
03/23/2015
Last updated
03/11/2016
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