Provider Demographics
NPI:1043964570
Name:DANG, VUONG DUC (PA)
Entity Type:Individual
Prefix:MR
First Name:VUONG
Middle Name:DUC
Last Name:DANG
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
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Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:360 N MAIN ST STE 2
Mailing Address - Street 2:
Mailing Address - City:SOUTHINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06489-2503
Mailing Address - Country:US
Mailing Address - Phone:860-621-1024
Mailing Address - Fax:860-620-9828
Practice Address - Street 1:360 N MAIN ST
Practice Address - Street 2:
Practice Address - City:SOUTHINGTON
Practice Address - State:CT
Practice Address - Zip Code:06489-2503
Practice Address - Country:US
Practice Address - Phone:860-621-1024
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-03
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant