Individual
KIM-ANH NGOC PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-C
Contact information
Practice address
201 MONARCH DR, LIVERPOOL, NY 13088-4506
(315) 615-4464
Mailing address
403 WELLS AVE W, NORTH SYRACUSE, NY 13212-2806
(315) 350-0695
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
—
—
363LF0000X
Family Nurse Practitioner
346281
NY
Other
Enumeration date
07/31/2020
Last updated
03/04/2025
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