Healthcare Provider Details

I. General information

NPI: 1336872183
Provider Name (Legal Business Name): TRINH HOANG OD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: EMMA HOANG OD

II. Dates (important events)

Enumeration Date: 07/07/2022
Last Update Date: 07/07/2022
Certification Date: 07/07/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

235 PARK AVE S
NEW YORK NY
10003-1405
US

IV. Provider business mailing address

1044 JACKSON AVE APT 5A
LONG ISLAND CITY NY
11101-6361
US

V. Phone/Fax

Practice location:
  • Phone: 212-844-2020
  • Fax:
Mailing address:
  • Phone: 253-670-8684
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number009579
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: