MEDICARE: VALERY DINH PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	11682	GA

General Provider Information

NPI Number	:	1023795531
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VALERY DINH PA-C

Provider Business Mailing Address
First Line	:	PO BOX 23329
Second Line	:
City	:	NEW YORK
State	:	NY
Zip	:	10087-3329
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1230 BALD RIDGE MARINA RD STE 300
Second Line	:
City	:	CUMMING
State	:	GA
Zip	:	30041-7859
Country	:	US
Telephone Number	:	770-814-8222
Fax Number	:	678-205-5111

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/28/2023
Last Update Date	:	03/31/2026

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Directions to “ VALERY DINH PA-C” Practice Location

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