MEDICARE: QUY TU NGUYEN

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	225100000X	Physical Therapist	PT031072	PA

General Provider Information

NPI Number	:	1619785151
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	QUY TU NGUYEN

Provider Business Mailing Address
First Line	:	123 RIDGEFIELD RD
Second Line	:
City	:	NEWTOWN SQUARE
State	:	PA
Zip	:	19073-3812
Country	:	US
Telephone Number	:	610-505-7733
Fax Number	:

Provider Business Practice Location Address
First Line	:	24 CYPRESS LN
Second Line	:
City	:	BERWYN
State	:	PA
Zip	:	19312-1066
Country	:	US
Telephone Number	:	610-675-4787
Fax Number	:

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

Provider Enumeration Date	:	12/30/2024
Last Update Date	:	12/30/2024

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Directions to “ QUY TU NGUYEN ” Practice Location

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