Individual
MS. PHUONG DINH LAM MAC
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1400 PELHAM PKWY S RM 5, BRONX, NY 10461-1197
(817) 918-5905
Mailing address
1400 PELHAM PKWY S BLDG 1, BRONX, NY 10461-1197
(718) 918-5905
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
025706
NY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/26/2020
Last updated
09/29/2020
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