Provider Demographics
NPI:1568461358
Name:HUYNH, DANH CONG (DO)
Entity Type:Individual
Prefix:
First Name:DANH
Middle Name:CONG
Last Name:HUYNH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 STATE ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16550-0002
Mailing Address - Country:US
Mailing Address - Phone:814-877-4922
Mailing Address - Fax:814-877-3622
Practice Address - Street 1:201 STATE ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16550-0002
Practice Address - Country:US
Practice Address - Phone:814-877-4922
Practice Address - Fax:814-877-3622
Is Sole Proprietor?:No
Enumeration Date:2005-07-14
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS008807L207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02138998OtherNY MEDICAID
PA1531885OtherGATEWAY
PA903240OtherBLUE SHIELD
PA152076OtherUNISON
PA207349OtherUPMC
PAP00111373OtherRR MEDICARE
NY00026543902OtherUNIVERA
PA3550310OtherAETNA
PA0016994770007Medicaid
WV1068779OtherW. VIRGINIA WORKERS COMP
PA0016994770007Medicaid
PA152076OtherUNISON