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General NPI Number Information
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NPI Number | 1417310202
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Entity Type | Individual
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Provider Name | PIMPIROON PLOYSANGAM
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Gender | Female
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Dates
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Enumeration Date | 03/30/2016
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 1600 ROCKLAND ROAD
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City | WILMINGTON
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State | DE
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Zip | 19803
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Country | US
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Telephone | 856-845-0100
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Fax | 302-651-4945
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Provider Business Mailing Address
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Address Line | PO BOX 191
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City | ROCKLAND
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State | DE
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Zip | 19732-0191
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Country | US
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Telephone | 302-651-6718
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Fax | 302-651-4945
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA12133900
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License Number State | NJ
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