MEDICARE: VICTORIA VUONG D.O.

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	207R00000X	Internal Medicine Physician	265478	NY
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207RR0500X	Rheumatology Physician	265478	NY

General Provider Information

NPI Number	:	1992947923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VICTORIA VUONG D.O.

Provider Business Mailing Address
First Line	:	500 W MAIN ST STE 110
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-3028
Country	:	US
Telephone Number	:	631-376-2663
Fax Number	:	631-376-4800

Provider Business Practice Location Address
First Line	:	500 W MAIN ST STE 110
Second Line	:
City	:	BABYLON
State	:	NY
Zip	:	11702-3028
Country	:	US
Telephone Number	:	631-376-2663
Fax Number	:	631-376-4800

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

Provider Enumeration Date	:	04/06/2009
Last Update Date	:	01/20/2016

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