MEDICARE: THUCDOAN HUYNH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD043538	DC
2	207Q00000X	Family Medicine Physician	262858	NY

General Provider Information

NPI Number	:	1831354182
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	THUCDOAN HUYNH MD

Provider Business Mailing Address
First Line	:	4600 WAVERLY AVE UNIT 421
Second Line	:
City	:	GARRETT PARK
State	:	MD
Zip	:	20896-7521
Country	:	US
Telephone Number	:	585-851-8482
Fax Number	:

Provider Business Practice Location Address
First Line	:	408 JAY ST FL 4
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11201-5150
Country	:	US
Telephone Number	:	855-961-1942
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/25/2008
Last Update Date	:	11/18/2020

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