Provider Demographics
NPI:1720562838
Name:NGUYEN, MINH DAO (DC, L AC, DIPL OM)
Entity Type:Individual
Prefix:
First Name:MINH DAO
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DC, L AC, DIPL OM
Other - Prefix:DR
Other - First Name:MINH DAO
Other - Middle Name:
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DC, L AC, DIPL OM
Mailing Address - Street 1:2-30 30TH ST
Mailing Address - Street 2:
Mailing Address - City:FAIR LAWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07410-3944
Mailing Address - Country:US
Mailing Address - Phone:201-790-6986
Mailing Address - Fax:
Practice Address - Street 1:53 PASSAIC ST
Practice Address - Street 2:
Practice Address - City:GARFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07026-3134
Practice Address - Country:US
Practice Address - Phone:973-894-3346
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-09-24
Last Update Date:2022-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MZ00133400171100000X
NJ38MC00755100111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Multi-Specialty
No171100000XOther Service ProvidersAcupuncturistGroup - Multi-Specialty