Provider Demographics
NPI:1427118157
Name:VO, TRACY T (MD)
Entity type:Individual
Prefix:DR
First Name:TRACY
Middle Name:T
Last Name:VO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 426
Mailing Address - Street 2:
Mailing Address - City:OLD WESTBURY
Mailing Address - State:NY
Mailing Address - Zip Code:11568-0426
Mailing Address - Country:US
Mailing Address - Phone:516-567-6838
Mailing Address - Fax:
Practice Address - Street 1:13511 40TH RD
Practice Address - Street 2:SUITE 4A
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5323
Practice Address - Country:US
Practice Address - Phone:718-961-1800
Practice Address - Fax:718-961-1802
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-11
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY212468207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
G93465Medicare UPIN
NY04941Medicare PIN