Healthcare Provider Details

I. General information

NPI: 1770105785
Provider Name (Legal Business Name): DUY CHAU NGOC NGUYEN
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/13/2020
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3970 PERKIOMEN AVE STE 202
READING PA
19606-2757
US

IV. Provider business mailing address

3970 PERKIOMEN AVE STE 202
READING PA
19606-2757
US

V. Phone/Fax

Practice location:
  • Phone: 610-779-1330
  • Fax: 610-779-7699
Mailing address:
  • Phone: 610-779-1330
  • Fax: 610-779-7699

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS022565
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: