Healthcare Provider Details

I. General information

NPI: 1912535808
Provider Name (Legal Business Name): MICHELLE THUY MAI DUONG MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2020
Last Update Date: 09/11/2026
Certification Date: 09/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 THEALL RD
RYE NY
10580-1404
US

IV. Provider business mailing address

1 THEALL RD
RYE NY
10580-1404
US

V. Phone/Fax

Practice location:
  • Phone: 914-848-8888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number345925
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: