Provider Demographics
NPI:1629633474
Name:NGUYEN, MINH THU THI (MD)
Entity Type:Individual
Prefix:DR
First Name:MINH THU
Middle Name:THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:MINH
Other - Middle Name:THI
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:263 FARMINGTON AVE
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06030-8074
Mailing Address - Country:US
Mailing Address - Phone:860-679-3158
Mailing Address - Fax:860-679-3159
Practice Address - Street 1:263 FARMINGTON AVE
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06030-8074
Practice Address - Country:US
Practice Address - Phone:860-679-3158
Practice Address - Fax:860-679-3159
Is Sole Proprietor?:No
Enumeration Date:2019-05-07
Last Update Date:2023-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT390200000X
NY390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program