MEDICARE: DR. DANG D NGUYEN M.D.

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	207RN0300X	Nephrology Physician	157328	NY
2	207RN0300X	Nephrology Physician	MA39872	NJ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1871512517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANG D NGUYEN M.D.

Provider Business Mailing Address
First Line	:	202 CANAL ST
Second Line	:	SUITE 305
City	:	NEW YORK
State	:	NY
Zip	:	10013-4517
Country	:	US
Telephone Number	:	212-334-8108
Fax Number	:	212-334-8147

Provider Business Practice Location Address
First Line	:	202 CANAL ST
Second Line	:	SUITE 305
City	:	NEW YORK
State	:	NY
Zip	:	10013-4517
Country	:	US
Telephone Number	:	212-334-8108
Fax Number	:	212-334-8147

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

Provider Enumeration Date	:	07/19/2006
Last Update Date	:	03/30/2017

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