Provider Demographics
NPI:1023244746
Name:NGUYEN, TONY TRUNG (DO)
Entity type:Individual
Prefix:DR
First Name:TONY
Middle Name:TRUNG
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:45 E NEWTON ST APT 706
Mailing Address - Street 2:
Mailing Address - City:BOSTON
Mailing Address - State:MA
Mailing Address - Zip Code:02118-4809
Mailing Address - Country:US
Mailing Address - Phone:415-531-3787
Mailing Address - Fax:
Practice Address - Street 1:45 E NEWTON ST APT 706
Practice Address - Street 2:
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02118-4809
Practice Address - Country:US
Practice Address - Phone:415-531-3787
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-09
Last Update Date:2022-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9533208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery