MEDICARE: NGUYEN PODIATRY DPM PC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213ES0103X	Foot & Ankle Surgery Podiatrist

General Provider Information

NPI Number	:	1548988710
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NGUYEN PODIATRY DPM PC

Provider Business Mailing Address
First Line	:	15018 41ST AVE
Second Line	:
City	:	FLUSHING
State	:	NY
Zip	:	11354-4945
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	420 74TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11209-2602
Country	:	US
Telephone Number	:	646-974-8723
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. VU NGUYEN
Credential	:
Telephone Number	:	646-974-8723

Provider Enumeration Date	:	08/15/2022
Last Update Date	:	08/15/2022

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