Provider Demographics
NPI:1720804651
Name:VU, TRUNG (PA)
Entity type:Individual
Prefix:
First Name:TRUNG
Middle Name:
Last Name:VU
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:JOEY
Other - Middle Name:
Other - Last Name:VU
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PA
Mailing Address - Street 1:1458 CHILI AVE
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14624-3263
Mailing Address - Country:US
Mailing Address - Phone:585-351-4733
Mailing Address - Fax:
Practice Address - Street 1:215 E STATE ST
Practice Address - Street 2:
Practice Address - City:ITHACA
Practice Address - State:NY
Practice Address - Zip Code:14850-5547
Practice Address - Country:US
Practice Address - Phone:607-274-3011
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-25
Last Update Date:2024-11-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program