Provider Demographics
NPI:1558503334
Name:GUAN, NICHOLAS NING-GUANG (MD)
Entity Type:Individual
Prefix:DR
First Name:NICHOLAS
Middle Name:NING-GUANG
Last Name:GUAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:217 E 7TH ST
Mailing Address - Street 2:UNIT 2B
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10009-5986
Mailing Address - Country:US
Mailing Address - Phone:212-961-7446
Mailing Address - Fax:
Practice Address - Street 1:391 E 10TH ST
Practice Address - Street 2:UNIT E
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10009-4770
Practice Address - Country:US
Practice Address - Phone:212-961-7446
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-25
Last Update Date:2009-03-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY2522582084P0800X, 2084P0805X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0805XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyGeriatric Psychiatry