Provider Demographics
NPI:1376668509
Name:VICTOR C. DY, M.D.P.C.
Entity Type:Organization
Organization Name:VICTOR C. DY, M.D.P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:VICTOR
Authorized Official - Middle Name:C
Authorized Official - Last Name:DY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:610-252-0358
Mailing Address - Street 1:3735 EASTON NAZARETH HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18045-8338
Mailing Address - Country:US
Mailing Address - Phone:610-252-0358
Mailing Address - Fax:610-258-5424
Practice Address - Street 1:3735 EASTON NAZARETH HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18045-8338
Practice Address - Country:US
Practice Address - Phone:610-252-0358
Practice Address - Fax:610-258-5424
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD035392-L208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0006266810001Medicaid
PA0006266810001Medicaid
PA141482Medicare ID - Type Unspecified