Provider Demographics
NPI:1851931430
Name:NGUYEN, OCEAN NGOC (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:OCEAN
Middle Name:NGOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 ELECTRIC AVE STE 102
Mailing Address - Street 2:
Mailing Address - City:FITCHBURG
Mailing Address - State:MA
Mailing Address - Zip Code:01420-7954
Mailing Address - Country:US
Mailing Address - Phone:978-343-7246
Mailing Address - Fax:978-343-7247
Practice Address - Street 1:33 ELECTRIC AVE STE 102
Practice Address - Street 2:
Practice Address - City:FITCHBURG
Practice Address - State:MA
Practice Address - Zip Code:01420-7954
Practice Address - Country:US
Practice Address - Phone:978-343-7246
Practice Address - Fax:978-343-7247
Is Sole Proprietor?:No
Enumeration Date:2020-01-10
Last Update Date:2022-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MAPA8277363A00000X, 363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant