Provider Demographics
NPI:1063415610
Name:APPLEGATE, BINH LUONG (CRNP)
Entity type:Individual
Prefix:
First Name:BINH
Middle Name:LUONG
Last Name:APPLEGATE
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 NORTH BROAD STREET
Mailing Address - Street 2:4TH FLOOR
Mailing Address - City:PHILADELPHIA
Mailing Address - State:PA
Mailing Address - Zip Code:19121
Mailing Address - Country:US
Mailing Address - Phone:215-204-3036
Mailing Address - Fax:215-204-4660
Practice Address - Street 1:1700 NORTH BROAD STREET
Practice Address - Street 2:4TH FLOOR
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19121
Practice Address - Country:US
Practice Address - Phone:215-204-3036
Practice Address - Fax:215-204-4660
Is Sole Proprietor?:No
Enumeration Date:2005-05-27
Last Update Date:2024-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASP008634363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA090379Medicare ID - Type UnspecifiedBINH'S MEDICARE #