Provider Demographics
NPI:1851971998
Name:DO, MYTRANG
Entity Type:Individual
Prefix:
First Name:MYTRANG
Middle Name:
Last Name:DO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1275 YORK AVE # 8
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10065-6007
Mailing Address - Country:US
Mailing Address - Phone:985-228-0757
Mailing Address - Fax:
Practice Address - Street 1:THE ROCKEFELLER UNIVERSITY
Practice Address - Street 2:1230 YORK AVENUE, # 144
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10065-1006
Practice Address - Country:US
Practice Address - Phone:985-228-0757
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-04-13
Last Update Date:2021-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program