Provider Demographics
NPI:1871690750
Name:TRIEU, CUONG N (OD)
Entity Type:Individual
Prefix:DR
First Name:CUONG
Middle Name:N
Last Name:TRIEU
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:54 WETMORE PARK
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14606-1422
Mailing Address - Country:US
Mailing Address - Phone:585-454-4630
Mailing Address - Fax:585-454-4631
Practice Address - Street 1:286 EXCHANGE BLVD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NY
Practice Address - Zip Code:14608-2707
Practice Address - Country:US
Practice Address - Phone:585-454-4630
Practice Address - Fax:585-454-4631
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYVUT005895152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist