Provider Demographics
NPI:1558669317
Name:NGUYEN, DANG (PA)
Entity Type:Individual
Prefix:
First Name:DANG
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:6 BUTTRICK RD
Mailing Address - Street 2:STE 102
Mailing Address - City:LONDONDERRY
Mailing Address - State:NH
Mailing Address - Zip Code:03053-3417
Mailing Address - Country:US
Mailing Address - Phone:603-537-1300
Mailing Address - Fax:603-845-5182
Practice Address - Street 1:50 MICHELS WAY STE 102
Practice Address - Street 2:
Practice Address - City:LONDONDERRY
Practice Address - State:NH
Practice Address - Zip Code:03053-3420
Practice Address - Country:US
Practice Address - Phone:603-537-1300
Practice Address - Fax:603-845-1830
Is Sole Proprietor?:No
Enumeration Date:2011-03-03
Last Update Date:2023-11-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NH0816363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical