Provider Demographics
NPI:1023147642
Name:HOANG, HAO TON (DPM)
Entity type:Individual
Prefix:DR
First Name:HAO
Middle Name:TON
Last Name:HOANG
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:MR
Other - First Name:HOA
Other - Middle Name:TON
Other - Last Name:HOANG
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MR
Mailing Address - Street 1:210 CANAL ST
Mailing Address - Street 2:SUITE 204
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4155
Mailing Address - Country:US
Mailing Address - Phone:212-571-7922
Mailing Address - Fax:212-571-7922
Practice Address - Street 1:210 CANAL ST
Practice Address - Street 2:SUITE 204
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4155
Practice Address - Country:US
Practice Address - Phone:212-571-7922
Practice Address - Fax:212-571-7922
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-02
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYN005275213E00000X, 213EP0504X, 213EP1101X, 213ER0200X, 213ES0000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ER0200XPodiatric Medicine & Surgery Service ProvidersPodiatristRadiology
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
No213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01897938Medicaid
NYP00056710Medicare ID - Type UnspecifiedRAILROAD CARRIER#
NYP99492Medicare ID - Type UnspecifiedMANHATTAN OFFICE
NYP99491Medicare ID - Type UnspecifiedLONGISLAND OFFICE
NYU69361Medicare UPIN