Provider Demographics
NPI:1780832642
Name:NATHALIE Q NGUYEN,MD PLLC
Entity Type:Organization
Organization Name:NATHALIE Q NGUYEN,MD PLLC
Other - Org Name:NATHALIE Q. NGUYEN,MD PLLC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:NATHALIE
Authorized Official - Middle Name:Q
Authorized Official - Last Name:NGUYEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD,PLLC
Authorized Official - Phone:212-233-2995
Mailing Address - Street 1:19 MURRAY ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-2240
Mailing Address - Country:US
Mailing Address - Phone:212-233-2995
Mailing Address - Fax:212-227-6577
Practice Address - Street 1:19 MURRAY ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-2240
Practice Address - Country:US
Practice Address - Phone:212-233-2995
Practice Address - Fax:212-227-6577
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:NATHALIE.Q NGUYEN,MD PLLC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-09-04
Last Update Date:2009-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225243174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
133936687OtherUPN ELITE
NY2570464OtherUNITED HEALTHCARE
NY366380101OtherHEALTHPLUS
NY3K5931OtherBLUE CROSS/ BLUE SHIELD
NYA17361Other1199
NYP3645118OtherOXFORD
NY7916771OtherAETNA
NY207500POtherHIP
NY2299249OtherGHI
NYOM3007OtherHEALTHNET
NY3K5541Medicare UPIN