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NPI Code Detail

MEDICARE: HONG HA THI NGUYEN OTR/L

MEDICARE: HONG HA THI NGUYEN OTR/L
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225X00000XOccupational TherapistOC006645LPA

General Provider Information

NPI Number : 1104010750
Entity Type Code : Individual
Provider Name (Legal Business Name) : HONG HA THI NGUYEN OTR/L
Provider Business Mailing Address
First Line : 407 CROYDEN RD
Second Line :
City : CHELTENHAM
State : PA
Zip : 19012-1611
Country : US
Telephone Number : 215-379-1414
Fax Number : 215-698-2749
Provider Business Practice Location Address
First Line : 10400 ROOSEVELT BLVD
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19116-3905
Country : US
Telephone Number : 215-698-5641
Fax Number : 215-698-2749
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2007
Last Update Date : 08/28/2007

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Directions to “ HONG HA THI NGUYEN OTR/L” Practice Location

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