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General NPI Number Information
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NPI Number | 1235628751
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Entity Type | Organization
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Legal Business Name | HEALTHY CONNECTIONS OF PENNSYLVANIA
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Dates
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Enumeration Date | 05/10/2018
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Last Update Date | 05/10/2018
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Provider Practice Location Address
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Address Line | 147 RED OAK DR
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City | LINCOLN UNIV
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State | PA
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Zip | 19352-8939
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Country | US
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Telephone | 302-607-3059
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Fax |
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Provider Business Mailing Address
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Address Line | 147 RED OAK DR
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City | LINCOLN UNIV
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State | PA
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Zip | 19352-8939
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MANAGING MEMBER
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Name | HIEN NGUYEN
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Credential | MD
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Telephone | 302-607-3059
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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