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General NPI Number Information
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NPI Number | 1871945808
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Entity Type | Organization
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Legal Business Name | VIP HEALTHCARE GROUP
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Dates
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Enumeration Date | 07/01/2016
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Last Update Date | 12/10/2019
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Provider Practice Location Address
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Address Line | 6043 N 5TH ST
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City | PHILADELPHIA
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State | PA
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Zip | 19120-1848
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Country | US
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Telephone | 917-593-2008
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Fax | 215-701-2254
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Provider Business Mailing Address
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Address Line | 6043 N 5TH STREET
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City | PHILADELPHIA
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State | PA
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Zip | 19120-9996
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Country | US
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Telephone | 917-593-2008
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Fax | 215-701-2254
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Authorized Official
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Title or Position | COO
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Name | DR. DAVID DUONG
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Credential | DPT
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Telephone | 215-992-4311
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT019240
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MD434225PE
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License Number State | PA
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