Provider Demographics
NPI:1184856700
Name:DINH, ANH PHUONG (OD)
Entity Type:Individual
Prefix:DR
First Name:ANH
Middle Name:PHUONG
Last Name:DINH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 RALSTON RD
Mailing Address - Street 2:
Mailing Address - City:BETHLEHEM
Mailing Address - State:PA
Mailing Address - Zip Code:18018-1814
Mailing Address - Country:US
Mailing Address - Phone:484-894-5065
Mailing Address - Fax:
Practice Address - Street 1:138 SPRING ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012-3854
Practice Address - Country:US
Practice Address - Phone:212-226-8276
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-15
Last Update Date:2012-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002205152W00000X
NYTUV007757152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist