Healthcare Provider Details

I. General information

NPI: 1578251203
Provider Name (Legal Business Name): MAI RACHEL NGUYEN MD, PHD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2023
Last Update Date: 07/02/2026
Certification Date: 07/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6 DEVINE ST
NORTH HAVEN CT
06473-2195
US

IV. Provider business mailing address

PO BOX 208013 333 CEDAR ST
NEW HAVEN CT
06520-8013
US

V. Phone/Fax

Practice location:
  • Phone: 203-287-6200
  • Fax: 203-287-6101
Mailing address:
  • Phone: 203-785-4170
  • Fax: 203-785-3229

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: