=====================================================
General NPI Number Information
=====================================================
NPI Number | 1992428684
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | STEVEN LAM NGUYEN L.AC, LMT
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/19/2022
-----------------------------------------------------
Last Update Date | 11/20/2024
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 32 UNION SQ E STE 612N
-----------------------------------------------------
City | NEW YORK
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 10003-3243
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-727-5157
-----------------------------------------------------
Fax | 929-500-0974
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 233 LEONARD ST
-----------------------------------------------------
City | BROOKLYN
-----------------------------------------------------
State | NY
-----------------------------------------------------
Zip | 11211-4805
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 917-587-7088
-----------------------------------------------------
Fax | 917-779-9188
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | 032577
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------
Taxonomy #2
-----------------------------------------------------
Taxonomy Code | 171100000X
-----------------------------------------------------
Taxonomy Name | Acupuncturist
-----------------------------------------------------
License Number | 007307
-----------------------------------------------------
License Number State | NY
-----------------------------------------------------