Provider Demographics
NPI:1053062257
Name:HOANG, DANIEL DUY (RD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:DUY
Last Name:HOANG
Suffix:
Gender:M
Credentials:RD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:485 OCEAN AVE APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11226-2907
Mailing Address - Country:US
Mailing Address - Phone:408-207-2448
Mailing Address - Fax:
Practice Address - Street 1:485 OCEAN AVE APT 2R
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11226-2907
Practice Address - Country:US
Practice Address - Phone:408-207-2448
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-10
Last Update Date:2022-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
86130858133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered