Healthcare Provider Details

I. General information

NPI: 1265988356
Provider Name (Legal Business Name): TRANG THUY NGUYEN CPNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/29/2016
Last Update Date: 12/09/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3415 BAINBRIDGE AVE
BRONX NY
10467-2403
US

IV. Provider business mailing address

650 W 42ND ST APT 1720
NEW YORK NY
10036-4373
US

V. Phone/Fax

Practice location:
  • Phone: 718-741-2332
  • Fax:
Mailing address:
  • Phone: 678-793-0161
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WP0200X
TaxonomyPediatric Registered Nurse
License Number636736-1
License Number StateNY
# 2
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License NumberF382671-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: