Provider Demographics
NPI:1528222866
Name:LE, NGUYET (MD)
Entity Type:Individual
Prefix:DR
First Name:NGUYET
Middle Name:
Last Name:LE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:132 S. 10TH STREET
Mailing Address - Street 2:2ND FLOOR, STE 285K
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19107-5244
Mailing Address - Country:US
Mailing Address - Phone:215-503-5642
Mailing Address - Fax:215-503-4817
Practice Address - Street 1:132 S 10TH ST
Practice Address - Street 2:2ND FLOOR, STE 285K
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19107-5244
Practice Address - Country:US
Practice Address - Phone:215-503-5642
Practice Address - Fax:215-503-4817
Is Sole Proprietor?:No
Enumeration Date:2008-07-16
Last Update Date:2014-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD440948207ZP0102X, 207ZB0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZB0001XAllopathic & Osteopathic PhysiciansPathologyBlood Banking & Transfusion Medicine
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA102511335Medicaid
NJ0240583Medicaid
PA102511335Medicaid