Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213ES0103X | Foot & Ankle Surgery | SC007182 | PA |
NPI | 1073191656 |
---|---|
Provider Name | Cindy Duong |
First Address | Philadelphia, PA 19125-1315 |
Second Address | Philadelphia, PA 19104-2640 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/04/2021 |
Last Update Date | 29/06/2021 |