Provider Demographics
NPI:1235583980
Name:DANG, MY-TRANG THI (DO, PHD)
Entity Type:Individual
Prefix:
First Name:MY-TRANG
Middle Name:THI
Last Name:DANG
Suffix:
Gender:F
Credentials:DO, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 N ACADEMY AVE
Mailing Address - Street 2:
Mailing Address - City:DANVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:17822-4903
Mailing Address - Country:US
Mailing Address - Phone:570-271-6144
Mailing Address - Fax:570-271-6578
Practice Address - Street 1:100 N ACADEMY AVE
Practice Address - Street 2:
Practice Address - City:DANVILLE
Practice Address - State:PA
Practice Address - Zip Code:17822-1356
Practice Address - Country:US
Practice Address - Phone:570-271-6164
Practice Address - Fax:570-271-6141
Is Sole Proprietor?:No
Enumeration Date:2016-04-19
Last Update Date:2022-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI5101022750207R00000X
PAOSO22137207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine