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General NPI Number Information
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NPI Number | 1265895445
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Entity Type | Individual
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Provider Name | BIANCA BAOTRAN THAI NGUYEN MD, MPH
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Gender | Female
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Dates
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Enumeration Date | 04/04/2016
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Last Update Date | 05/06/2021
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Provider Practice Location Address
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Address Line | 55 BROADWAY
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City | NEW YORK
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State | NY
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Zip | 10006-3008
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Country | US
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Telephone | 646-315-2180
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Fax |
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Provider Business Mailing Address
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Address Line | 335 W 84TH ST APT 3
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City | NEW YORK
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State | NY
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Zip | 10024-4229
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Country | US
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Telephone | 704-996-3831
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 291320-01
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License Number State | NY
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