1952361883 NPI number — THUY T NGUYEN MD FACS

Table of content: THUY T NGUYEN MD FACS (NPI 1952361883)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1952361883 NPI number — THUY T NGUYEN MD FACS

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
THUY
Provider Middle Name:
T
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD FACS
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:
1952361883
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/25/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2500 NESCONSET HWY
Provider Second Line Business Mailing Address:
BILLING DEPT SUITE 4D NGUYEN PLASTIC SURGERY PC
Provider Business Mailing Address City Name:
STONY BROOK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11790
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
631-689-6500
Provider Business Mailing Address Fax Number:
631-689-6521

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2500 NESCONSET HWY
Provider Second Line Business Practice Location Address:
SUITE 4A NGUYEN PLASTIC SURGERY PC
Provider Business Practice Location Address City Name:
STONY BROOK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11790
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
631-689-6500
Provider Business Practice Location Address Fax Number:
631-689-6521
Provider Enumeration Date:
03/24/2006

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: 208200000X , with the licence number:  193693 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: 1952361883 . This is a "A400079102" identifier . This identifiers is of the category "OTHER".