Healthcare Provider Details

I. General information

NPI: 1356269666
Provider Name (Legal Business Name): HUYEN NGUYEN PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2026
Last Update Date: 07/07/2026
Certification Date: 06/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

243 DELAWARE ST
WALTON NY
13856-1019
US

IV. Provider business mailing address

76 PENNSYLVANIA AVE APT 12
BINGHAMTON NY
13903-1627
US

V. Phone/Fax

Practice location:
  • Phone: 607-832-5888
  • Fax: 607-832-6081
Mailing address:
  • Phone: 607-761-4765
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number407834
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: