Provider Demographics
NPI:1558588079
Name:NGUYEN, SCOTT Q (MD)
Entity Type:Individual
Prefix:
First Name:SCOTT
Middle Name:Q
Last Name:NGUYEN
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1 GUSTAVE L LEVY PL
Mailing Address - Street 2:BOX 1263
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-241-1483
Mailing Address - Fax:212-534-2654
Practice Address - Street 1:5 EAST 98TH STREET
Practice Address - Street 2:14TH FL
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10029-6574
Practice Address - Country:US
Practice Address - Phone:212-241-1483
Practice Address - Fax:212-534-2654
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-18
Last Update Date:2010-01-25
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Provider Licenses
StateLicense IDTaxonomies
NY231235208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02889196Medicaid
NY02889196Medicaid