Healthcare Provider Details

I. General information

NPI: 1619891686
Provider Name (Legal Business Name): DR. DIANA THAI DUONG
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

170 WILLIAM ST
NEW YORK NY
10038-2612
US

IV. Provider business mailing address

345 W 145TH ST APT 7A6
NEW YORK NY
10031-5316
US

V. Phone/Fax

Practice location:
  • Phone: 212-312-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835E0208X
TaxonomyEmergency Medicine Pharmacist
License Number066148
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: