Healthcare Provider Details

I. General information

NPI: 1003530288
Provider Name (Legal Business Name): D'LYN NGUYEN ARNAMNART PTA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2022
Last Update Date: 09/30/2022
Certification Date: 09/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

103 HOSPITAL LOOP NE
ALBUQUERQUE NM
87109-2115
US

IV. Provider business mailing address

103 HOSPITAL LOOP NE
ALBUQUERQUE NM
87109-2115
US

V. Phone/Fax

Practice location:
  • Phone: 505-348-8300
  • Fax:
Mailing address:
  • Phone: 505-348-8300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225200000X
TaxonomyPhysical Therapy Assistant
License NumberPTA1585
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: