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General NPI Number Information
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NPI Number | 1922499813
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Entity Type | Individual
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Provider Name | PHUONG LE
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Gender | Female
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Dates
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Enumeration Date | 02/12/2015
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Last Update Date | 11/28/2020
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Provider Practice Location Address
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Address Line | 337 MAPLE AVE E
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City | VIENNA
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State | VA
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Zip | 22180-4717
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Country | US
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Telephone | 703-938-2374
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Fax |
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Provider Business Mailing Address
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Address Line | 3474 PENCE CT
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City | ANNANDALE
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State | VA
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Zip | 22003-1424
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Country | US
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Telephone | 571-457-4847
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Fax |
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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 | 183700000X
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Taxonomy Name | Pharmacy Technician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 0202216152
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License Number State | VA
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