1558503334 NPI number — DR. NICHOLAS NING-GUANG GUAN MD

Table of content: DR. NICHOLAS NING-GUANG GUAN MD (NPI 1558503334)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558503334 NPI number — DR. NICHOLAS NING-GUANG GUAN MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GUAN
Provider First Name:
NICHOLAS
Provider Middle Name:
NING-GUANG
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1558503334
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/25/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
217 E 7TH ST
Provider Second Line Business Mailing Address:
UNIT 2B
Provider Business Mailing Address City Name:
NEW YORK
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10009-5986
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
212-961-7446
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
391 E 10TH ST
Provider Second Line Business Practice Location Address:
UNIT E
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10009-4770
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
212-961-7446
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/25/2009

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: 2084P0800X , with the licence number:  252258 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 2084P0805X , with the licence number: 252258 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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





Copyright © 2007-2025 www.npivalidator.com