Healthcare Provider Details

I. General information

NPI: 1023147642
Provider Name (Legal Business Name): HAO TON HOANG D.P.M
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: HOA TON HOANG MR.

II. Dates (important events)

Enumeration Date: 03/02/2007
Last Update Date: 01/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

210 CANAL ST SUITE 204
NEW YORK NY
10013-4155
US

IV. Provider business mailing address

210 CANAL ST SUITE 204
NEW YORK NY
10013-4155
US

V. Phone/Fax

Practice location:
  • Phone: 212-571-7922
  • Fax: 212-571-7922
Mailing address:
  • Phone: 212-571-7922
  • Fax: 212-571-7922

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN005275
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code213EP0504X
TaxonomyPublic Medicine Podiatrist
License NumberN005275
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License NumberN005275
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code213ER0200X
TaxonomyRadiology Podiatrist
License NumberN005275
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code213ES0000X
TaxonomySports Medicine Podiatrist
License NumberN005275
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License NumberN005275
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: