MEDICARE: MR. SINH TRUONG

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	183500000X	Pharmacist	027913	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1598087553
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. SINH TRUONG

Provider Business Mailing Address
First Line	:	2806 213TH ST
Second Line	:
City	:	BAYSIDE
State	:	NY
Zip	:	11360-2535
Country	:	US
Telephone Number	:	917-886-3189
Fax Number	:

Provider Business Practice Location Address
First Line	:	2272 86TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11214-4138
Country	:	US
Telephone Number	:	718-872-5737
Fax Number	:

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

Provider Enumeration Date	:	02/18/2010
Last Update Date	:	02/18/2010

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