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General NPI Number Information
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NPI Number | 1649318056
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Entity Type | Individual
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Provider Name | NATHALIE Q NGUYEN M.D,PLLC
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Gender | Female
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Dates
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Enumeration Date | 02/01/2007
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Last Update Date | 12/01/2021
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Provider Practice Location Address
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Address Line | 291 BROADWAY SUITE 1803
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City | NEW YORK
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State | NY
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Zip | 10007-1814
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Country | US
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Telephone | 212-233-2995
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Fax | 212-227-6577
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Provider Business Mailing Address
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Address Line | 291 BROADWAY RM 1803
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City | NEW YORK
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State | NY
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Zip | 10007-1889
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Country | US
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Telephone | 212-233-2995
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Fax | 212-227-6577
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 225243
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License Number State | NY
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