Provider Demographics
NPI:1528684636
Name:DUONG, BRYAN AN (LIAC)
Entity type:Individual
Prefix:
First Name:BRYAN
Middle Name:AN
Last Name:DUONG
Suffix:
Gender:M
Credentials:LIAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 J A MCDERMOTT CIR
Mailing Address - Street 2:
Mailing Address - City:RANDOLPH
Mailing Address - State:MA
Mailing Address - Zip Code:02368-2753
Mailing Address - Country:US
Mailing Address - Phone:781-535-4269
Mailing Address - Fax:
Practice Address - Street 1:90 ROCKLAND ST
Practice Address - Street 2:
Practice Address - City:HANOVER
Practice Address - State:MA
Practice Address - Zip Code:02339-2235
Practice Address - Country:US
Practice Address - Phone:781-829-9355
Practice Address - Fax:833-588-8455
Is Sole Proprietor?:No
Enumeration Date:2020-06-24
Last Update Date:2020-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist