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General NPI Number Information
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NPI Number | 1285263491
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Entity Type | Individual
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Provider Name | TRONG PHU NGUYEN MD
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Gender | Male
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Dates
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Enumeration Date | 04/08/2020
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Last Update Date | 10/21/2024
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Provider Practice Location Address
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Address Line | 333 CEDAR ST
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City | NEW HAVEN
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State | CT
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Zip | 06510-3206
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Country | US
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Telephone | 832-513-9172
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Fax |
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Provider Business Mailing Address
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Address Line | 209 OAKWOOD RD
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City | HUNTINGTON
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State | NY
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Zip | 11743-4252
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Country | US
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Telephone | 832-513-9172
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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 | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 327209
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 79576
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License Number State | CT
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