Healthcare Provider Details

I. General information

NPI: 1619182888
Provider Name (Legal Business Name): HANG THU NGUYEN DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 05/23/2024
Certification Date: 05/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1220 BROADCASTING RD STE 100
WYOMISSING PA
19610-3221
US

IV. Provider business mailing address

PO BOX 13579
READING PA
19612-3579
US

V. Phone/Fax

Practice location:
  • Phone: 484-628-5673
  • Fax: 610-371-8623
Mailing address:
  • Phone: 484-628-1324
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS013865
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberC2-0009294
License Number StateDE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: