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General NPI Number Information
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NPI Number | 1023784618
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Entity Type | Organization
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Legal Business Name | TRIAGE CARE LLC
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Dates
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Enumeration Date | 08/23/2021
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Last Update Date | 11/24/2021
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Provider Practice Location Address
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Address Line | 679 62ND ST
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City | BROOKLYN
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State | NY
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Zip | 11220-4112
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Country | US
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Telephone | 917-682-1932
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Fax |
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Provider Business Mailing Address
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Address Line | 679 62ND ST
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City | BROOKLYN
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State | NY
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Zip | 11220-4112
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Country | US
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Telephone | 917-682-1932
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN ASSISTANT
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Name | MR. SIMON DUONG
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Credential | RPA-C
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Telephone | 917-682-1932
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number |
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License Number State |
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