MEDICARE: DR. ASHLIE NGUYEN PSYD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	103T00000X	Psychologist

General Provider Information

NPI Number	:	1366261786
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ASHLIE NGUYEN PSYD

Provider Business Mailing Address
First Line	:	794 WEGMAN RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14624-1437
Country	:	US
Telephone Number	:	585-278-2073
Fax Number	:

Provider Business Practice Location Address
First Line	:	2535 BRIGHTON HENRIETTA TOWN LINE RD
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14623-2711
Country	:	US
Telephone Number	:	585-204-0294
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/03/2024
Last Update Date	:	01/20/2026

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