Provider Demographics
NPI:1649318056
Name:NGUYEN, NATHALIE Q (MD,PLLC)
Entity type:Individual
Prefix:DR
First Name:NATHALIE
Middle Name:Q
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:MD,PLLC
Other - Prefix:
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Mailing Address - Street 1:291 BROADWAY RM 1803
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10007-1889
Mailing Address - Country:US
Mailing Address - Phone:212-233-2995
Mailing Address - Fax:212-227-6577
Practice Address - Street 1:291 BROADWAY
Practice Address - Street 2:SUITE 1803
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10007-1814
Practice Address - Country:US
Practice Address - Phone:212-233-2995
Practice Address - Fax:212-227-6577
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-01
Last Update Date:2021-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY225243207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY7916771OtherAETNA
366380101OtherHEALTHPLUS
OM3007OtherHEALTHNET
203012801OtherPHCS
225243OtherMETROPLUS
2299249OtherGHI
2570464OtherUNITED HEALTHCARE
3K5931OtherBLUE CROSS/BLUESHIELD
A17361Other1199
133936687OtherUPN ELITE
203012801OtherNYSHIP
207500POtherHIP
NY203012801OtherBEECHSTREET
NY203012801OtherTAX ID #
203012801OtherMULTIPLAN
P3645118OtherOXFORD
NY0643877OtherCIGNA
203012801OtherPHCS