Provider Demographics
NPI:1467631036
Name:QUACH, VI (MD)
Entity Type:Individual
Prefix:
First Name:VI
Middle Name:
Last Name:QUACH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:160 E 84TH ST
Mailing Address - Street 2:10L
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10028-2008
Mailing Address - Country:US
Mailing Address - Phone:646-258-2574
Mailing Address - Fax:
Practice Address - Street 1:83-45 DONGAN AVE
Practice Address - Street 2:
Practice Address - City:QUEENS
Practice Address - State:NY
Practice Address - Zip Code:11373-3755
Practice Address - Country:US
Practice Address - Phone:646-258-2574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2010-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY246652207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine