Individual
PRICHA BOONSWANG
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2358 GRUVER AVE, EASTON, PA 18045-2808
(610) 252-2229
(610) 252-8468
Mailing address
2358 GRUVER AVE, EASTON, PA 18045-2808
(610) 252-2229
(610) 252-8468
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
MD033757L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0006479210002
—
PA
01
—
0050575000
KHP EAST
—
01
—
0990471
KHP CENRAL
—
05
—
4961200
—
NJ
Enumeration date
12/28/2005
Last updated
02/24/2010
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