Provider Demographics
NPI:1558471672
Name:NGUYEN, YEN-LINH TRINH (OD)
Entity Type:Individual
Prefix:DR
First Name:YEN-LINH
Middle Name:TRINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:439 S UNION ST
Mailing Address - Street 2:BLDG. 1, STE 1101
Mailing Address - City:LAWRENCE
Mailing Address - State:MA
Mailing Address - Zip Code:01843-2837
Mailing Address - Country:US
Mailing Address - Phone:978-686-2983
Mailing Address - Fax:
Practice Address - Street 1:439 S UNION ST
Practice Address - Street 2:BLDG. 1, STE. 1101
Practice Address - City:LAWRENCE
Practice Address - State:MA
Practice Address - Zip Code:01843-2837
Practice Address - Country:US
Practice Address - Phone:978-686-2983
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4550152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAV08881Medicare UPIN
MAW17638Medicare ID - Type Unspecified