Healthcare Provider Details

I. General information

NPI: 1881529907
Provider Name (Legal Business Name): TOMMY HUYNH LE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 EMORY ST UNIT 313
ASBURY PARK NJ
07712-7154
US

IV. Provider business mailing address

300 EMORY ST UNIT 313
ASBURY PARK NJ
07712-7154
US

V. Phone/Fax

Practice location:
  • Phone: 703-678-8333
  • Fax:
Mailing address:
  • Phone: 703-678-8333
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: