Justin Thai Thach, PA
NPI #1558558395 in College Point, New York
Provider Information
- NPI Number
- 1558558395
- Entity Type
- Individual
- Name
- Justin Thai Thach, PA
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Physician Assistant - Surgical
- Credential
- PA
- Enumeration Date
- Sep 25, 2007
- Last Updated
- Dec 9, 2015
Practice Location
- Address
- 1217 119TH ST
- City
- College Point
- State
- New York
- ZIP Code
- 11356-1648
- Phone
- (646) 898-7446
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant - Surgical — Surgical |
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