Healthcare Provider Details

I. General information

NPI: 1306273925
Provider Name (Legal Business Name): 1-2-3 OSTEOPATHY PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/27/2013
Last Update Date: 08/11/2022
Certification Date: 08/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

186 W MONTAUK HWY STE D11
HAMPTON BAYS NY
11946-4205
US

IV. Provider business mailing address

186 W MONTAUK HWY STE D11
HAMPTON BAYS NY
11946-4205
US

V. Phone/Fax

Practice location:
  • Phone: 631-204-5400
  • Fax: 631-204-5401
Mailing address:
  • Phone: 631-204-5400
  • Fax: 631-204-5401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code204D00000X
TaxonomyNeuromusculoskeletal Medicine & OMM Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TRANG B NGUYEN
Title or Position: PHYSICIAN
Credential: D.O.
Phone: 631-204-5400