Individual
TERRY PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NUTRITIONIST
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
005564
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
005561
LICENSE
NY
Enumeration date
10/13/2006
Last updated
12/17/2012
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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