Provider Demographics
NPI:1356510747
Name:NGUYEN, ANN L (MD)
Entity Type:Individual
Prefix:
First Name:ANN
Middle Name:L
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 W 12TH ST
Mailing Address - Street 2:SMITH BUILDING, 8TH FLOOR
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-8202
Mailing Address - Country:US
Mailing Address - Phone:212-604-8630
Mailing Address - Fax:
Practice Address - Street 1:170 W 12TH ST
Practice Address - Street 2:SMITH BUILDING, 8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-8202
Practice Address - Country:US
Practice Address - Phone:212-604-8630
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-29
Last Update Date:2008-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY235153208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics