Provider Demographics
NPI:1184737918
Name:NGUYEN, PATRICIA MY-LAN (MD)
Entity type:Individual
Prefix:DR
First Name:PATRICIA
Middle Name:MY-LAN
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99 EAST STATE STREET
Mailing Address - Street 2:PO BOX 1250
Mailing Address - City:GLOVERSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:12078
Mailing Address - Country:US
Mailing Address - Phone:518-773-5729
Mailing Address - Fax:518-775-4118
Practice Address - Street 1:99 EAST STATE STREET
Practice Address - Street 2:MAB-GPCC
Practice Address - City:GLOVERSVILLE
Practice Address - State:NY
Practice Address - Zip Code:12078
Practice Address - Country:US
Practice Address - Phone:518-773-5729
Practice Address - Fax:518-775-4118
Is Sole Proprietor?:No
Enumeration Date:2006-08-16
Last Update Date:2015-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY210073207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000490195001OtherBSH NE NY
NY15456OtherMVP HEALTH PLAN
NY02007894Medicaid
NY10027129OtherCDPHP
NY02007894Medicaid
NYBB0845Medicare PIN