Provider Demographics
NPI:1174967426
Name:HOANG, MICHELLE PHI (MD)
Entity type:Individual
Prefix:
First Name:MICHELLE
Middle Name:PHI
Last Name:HOANG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 416457
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02241-6457
Mailing Address - Country:US
Mailing Address - Phone:844-362-1735
Mailing Address - Fax:973-290-7495
Practice Address - Street 1:23 MOUNTAIN BLVD
Practice Address - Street 2:
Practice Address - City:WARREN
Practice Address - State:NJ
Practice Address - Zip Code:07059-5611
Practice Address - Country:US
Practice Address - Phone:908-598-7970
Practice Address - Fax:908-322-4989
Is Sole Proprietor?:No
Enumeration Date:2013-04-17
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJ390200000X
NJ25MA09982700207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program