Provider Demographics
NPI:1871512517
Name:NGUYEN, DANG D (MD)
Entity Type:Individual
Prefix:DR
First Name:DANG
Middle Name:D
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:DUNG
Other - Middle Name:DANG
Other - Last Name:NGUYEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:202 CANAL ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10013-4517
Mailing Address - Country:US
Mailing Address - Phone:212-334-8108
Mailing Address - Fax:212-334-8147
Practice Address - Street 1:202 CANAL ST
Practice Address - Street 2:SUITE 305
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10013-4517
Practice Address - Country:US
Practice Address - Phone:212-334-8108
Practice Address - Fax:212-334-8147
Is Sole Proprietor?:No
Enumeration Date:2006-07-19
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY157328207RN0300X
NJMA39872207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00923166Medicaid
NYA62616Medicare UPIN
NY39D211Medicare ID - Type UnspecifiedMEDICARE PROVIDER ID #
NYWGW141Medicare PIN