Healthcare Provider Details

I. General information

NPI: 1760877617
Provider Name (Legal Business Name): HAI HOANG MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/30/2015
Last Update Date: 11/10/2025
Certification Date: 11/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

525 E 68TH ST STE 610
NEW YORK NY
10065-4870
US

IV. Provider business mailing address

401 E 58TH ST APT A1
NEW YORK NY
10022-2316
US

V. Phone/Fax

Practice location:
  • Phone: 212-746-0225
  • Fax:
Mailing address:
  • Phone: 917-943-2588
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberME161543
License Number StateFL
# 2
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberME161543
License Number StateFL
# 3
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number298793
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: