| Doctor Name: | MS. PHUONG NGO |
| NPI Number: | 1043636301 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | CRNP |
| License Number: | LB-0000290 |
| Business Practice Address: | 1068 W Baltimore Pike Media, PA - 190635104 |
| Business Phone Number: | 4842273218 |
| Business Fax Number: | |
| Mailing Address: | 1068 W Baltimore Pike, MEDIA |
| State: | PA |
| Postal Code: | 190635104 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 03/11/2014 |
| NPI Last Update Date: | 12/13/2015 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363LA2200X |
| License Number: | LB-0000290 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | DE |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Nurse Practitioner |
| Taxonomy Specialization: | Adult Health |
| Taxonomy Definition: | |