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NPI Code Detail

MEDICARE: THUY TRONG THAN M.D.

MEDICARE: THUY TRONG THAN M.D.
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
1207L00000XAnesthesiology PhysicianD0044597MD

General Provider Information

NPI Number : 1861498446
Entity Type Code : Individual
Provider Name (Legal Business Name) : THUY TRONG THAN M.D.
Provider Business Mailing Address
First Line : 66 POWERHOUSE RD
Second Line : FL 3
City : ROSLYN HTS
State : NY
Zip : 11577-1324
Country : US
Telephone Number : 516-626-6366
Fax Number :
Provider Business Practice Location Address
First Line : 5401 OLD COURT RD
Second Line :
City : RANDALLSTOWN
State : MD
Zip : 21133-5103
Country : US
Telephone Number : 410-521-2200
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/28/2005
Last Update Date : 07/08/2007

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