Provider Demographics
NPI:1972727683
Name:NGUYEN, ANN MY (OD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:MY
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:62 GRAND CENTRAL TERMINAL
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-5622
Mailing Address - Country:US
Mailing Address - Phone:212-599-1220
Mailing Address - Fax:212-687-5414
Practice Address - Street 1:360 POST ST STE 1005
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94108-4913
Practice Address - Country:US
Practice Address - Phone:415-982-2020
Practice Address - Fax:415-982-2011
Is Sole Proprietor?:No
Enumeration Date:2007-04-12
Last Update Date:2022-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYTUV007140-1152W00000X
CA12456152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY04667Medicare UPIN