Provider Demographics
NPI:1366818783
Name:LE, PHUONG UYEN (DO)
Entity Type:Individual
Prefix:DR
First Name:PHUONG
Middle Name:UYEN
Last Name:LE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 783311
Mailing Address - Street 2:
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19178-3311
Mailing Address - Country:US
Mailing Address - Phone:484-884-4500
Mailing Address - Fax:484-884-0699
Practice Address - Street 1:1255 S CEDAR CREST BLVD STE 2100
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-6226
Practice Address - Country:US
Practice Address - Phone:610-402-6555
Practice Address - Fax:610-402-6550
Is Sole Proprietor?:No
Enumeration Date:2015-08-19
Last Update Date:2018-10-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ25MB101381002081P2900X
PAOS0195492081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine