Provider Demographics
NPI:1700985199
Name:PHAM, VINH PHILIP (MD PHD)
Entity Type:Individual
Prefix:
First Name:VINH
Middle Name:PHILIP
Last Name:PHAM
Suffix:
Gender:M
Credentials:MD PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:545 1ST AVE
Mailing Address - Street 2:GREENBERG HALL SC1-174
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6401
Mailing Address - Country:US
Mailing Address - Phone:212-263-5454
Mailing Address - Fax:212-263-0523
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:SCHWARTZ HCC EAST SUITE 7B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:646-501-9936
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-21
Last Update Date:2014-11-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY217182207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYI24842Medicare UPIN