=====================================================
General NPI Number Information
=====================================================
NPI Number | 1578474771
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | LINSEY NGUYEN
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/15/2026
-----------------------------------------------------
Last Update Date | 09/15/2026
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 408 RIO GRANDE AVE
-----------------------------------------------------
City | RIO GRANDE
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08242-2018
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-204-4849
-----------------------------------------------------
Fax | 609-383-8340
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 200 WALTON RD
-----------------------------------------------------
City | EGG HARBOR TOWNSHIP
-----------------------------------------------------
State | NJ
-----------------------------------------------------
Zip | 08234-6401
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 609-742-7757
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225100000X
-----------------------------------------------------
Taxonomy Name | Physical Therapist
-----------------------------------------------------
License Number | 40QA02450300
-----------------------------------------------------
License Number State | NJ
-----------------------------------------------------