1942210034 NPI number — DR. MY-HANH TRIEU O.D.

Table of content: DR. MY-HANH TRIEU O.D. (NPI 1942210034)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942210034 NPI number — DR. MY-HANH TRIEU O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TRIEU
Provider First Name:
MY-HANH
Provider Middle Name:
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942210034
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/12/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
6015A WILSON BLVD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ARLINGTON
Provider Business Mailing Address State Name:
VA
Provider Business Mailing Address Postal Code:
22205-1503
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
703-534-8801
Provider Business Mailing Address Fax Number:
703-534-8803

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6015A WILSON BLVD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
ARLINGTON
Provider Business Practice Location Address State Name:
VA
Provider Business Practice Location Address Postal Code:
22205-1503
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
703-534-8801
Provider Business Practice Location Address Fax Number:
703-534-8803
Provider Enumeration Date:
08/09/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  0618000725 , registered in the state of VA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 44447 . This is a "DAVIS VISION" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1717457 . This is a "ALL AETNA PLANS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1717457 . This is a "PHCS PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1717457 . This is a "NCAS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 137406 . This is a "ANTHEM PPO, HMO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: J254 . This is a "CAREFIRST BCBS PPO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: VA2285 . This is a "EYEMED" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 17591 . This is a "COLE MANAGED VISION" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 269475 . This is a "ALLIANCE, UNITED HC, MAMS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 31691 . This is a "AVESIS" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 487248 . This is a "NATIONAL VISION ADMINISTR" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: VA02285 . This is a "VISION BENEFIT OF AMERICA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1717457 . This is a "SUPERIOR VISION SERVICES" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 469475 . This is a "MDIPA, MAMSI, OPTIMUM CHO" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 1202001 . This is a "ALLIED EYECARE" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: TE23963 . This is a "SPECTERA" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 06-1717457 . This is a "GEMGROUP" identifier , issued by the state of ( VA ) . This identifiers is of the category "OTHER".
  • Identifier: 10051304 , issued by the state of ( VA ) . This identifiers is of the category "MEDICAID".




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