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Individual

TONY QUACH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
56-45 MAIN ST, 4TH FLOOR SOUTH, FLUSHING, NY 11355-5045
(718) 670-6824
Mailing address
56-45 MAIN ST, 4TH FLOOR SOUTH, FLUSHING, NY 11355-5045
(718) 670-6824

Taxonomy

Speciality
Code
Description
License number
State
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
239205
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00669
MEDICARE GROUP NUMBER
NY
01
02993566
MEDICAID GROUP
NY
05
03123580
NY
01
P00871365
RAILROAD MEDICARE
NY
Enumeration date
04/14/2009
Last updated
08/09/2023
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