Provider Demographics
NPI:1235628751
Name:HEALTHY CONNECTIONS OF PENNSYLVANIA
Entity Type:Organization
Organization Name:HEALTHY CONNECTIONS OF PENNSYLVANIA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:HIEN
Authorized Official - Middle Name:
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:302-607-3059
Mailing Address - Street 1:147 RED OAK DR
Mailing Address - Street 2:
Mailing Address - City:LINCOLN UNIV
Mailing Address - State:PA
Mailing Address - Zip Code:19352-8939
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:147 RED OAK DR
Practice Address - Street 2:
Practice Address - City:LINCOLN UNIV
Practice Address - State:PA
Practice Address - Zip Code:19352-8939
Practice Address - Country:US
Practice Address - Phone:302-607-3059
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-05-10
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty