Provider Demographics
NPI:1295890564
Name:NGUYEN, HUNG QUOC (MD)
Entity type:Individual
Prefix:
First Name:HUNG
Middle Name:QUOC
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 BETHANY RD
Mailing Address - Street 2:STE 91
Mailing Address - City:HAZLET
Mailing Address - State:NJ
Mailing Address - Zip Code:07730-1669
Mailing Address - Country:US
Mailing Address - Phone:732-888-9400
Mailing Address - Fax:732-888-0498
Practice Address - Street 1:1 BETHANY RD
Practice Address - Street 2:STE 91
Practice Address - City:HAZLET
Practice Address - State:NJ
Practice Address - Zip Code:07730-1669
Practice Address - Country:US
Practice Address - Phone:732-888-9400
Practice Address - Fax:732-888-0498
Is Sole Proprietor?:No
Enumeration Date:2006-12-26
Last Update Date:2017-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ63309208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ038609MJ4Medicare ID - Type Unspecified