Pham, Thao Phuong
Pham, Thao Phuong is an individual health care provider with primary practice located at 79-01 Broadway Managed Care, D1-01, Elmhurst NY 11373-1329. He recently has only one registered license in Behavioral Health & Social Service Providers / Social Worker, which is considered as his primary health care specialty. Pham, Thao Phuong can be contacted via phone (718) 334-1921.Contact Information
Primary practice address
79-01 Broadway Managed Care, D1-01
Elmhurst NY 11373-1329
Phone: (718) 334-1921
Fax: (718) 334-5958
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Social Worker | 104100000X | 059121 | New York |
Profile Details
| NPI number | 1336247063 |
|---|---|
| LBN Legal business name | Pham, Thao Phuong |
| Credentials | LMSW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 20th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1336247063 | NPPES |
| New York | MEDICAID | 00246075 |
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