Provider Demographics
NPI:1518695832
Name:NGUYEN, CHAU NGOC MINH
Entity Type:Individual
Prefix:
First Name:CHAU
Middle Name:NGOC MINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:71 ROBERTSON ST
Mailing Address - Street 2:
Mailing Address - City:QUINCY
Mailing Address - State:MA
Mailing Address - Zip Code:02169-1216
Mailing Address - Country:US
Mailing Address - Phone:617-784-9350
Mailing Address - Fax:
Practice Address - Street 1:16 MOON ISLAND RD
Practice Address - Street 2:
Practice Address - City:QUINCY
Practice Address - State:MA
Practice Address - Zip Code:02171-1034
Practice Address - Country:US
Practice Address - Phone:617-774-1040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-13
Last Update Date:2022-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker