Healthcare Provider Details

I. General information

NPI: 1215544234
Provider Name (Legal Business Name): ANNA HOANG OTR/L
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/24/2020
Last Update Date: 09/24/2020
Certification Date: 09/24/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 W 34TH ST APT 7C3
NEW YORK NY
10001-3049
US

IV. Provider business mailing address

50 W 34TH ST APT 7C3
NEW YORK NY
10001-3049
US

V. Phone/Fax

Practice location:
  • Phone: 714-757-7241
  • Fax:
Mailing address:
  • Phone: 714-757-7241
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225X00000X
TaxonomyOccupational Therapist
License Number024807
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: