Provider Demographics
NPI:1831157478
Name:NGUYEN, TUAN QUYNH ANH (MD)
Entity type:Individual
Prefix:
First Name:TUAN
Middle Name:QUYNH ANH
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 1:431 PARK AVE
Mailing Address - Street 2:SUITE 103
Mailing Address - City:FALLS CHURCH
Mailing Address - State:VA
Mailing Address - Zip Code:22046-3305
Mailing Address - Country:US
Mailing Address - Phone:703-534-4393
Mailing Address - Fax:703-992-8158
Practice Address - Street 1:431 PARK AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:FALLS CHURCH
Practice Address - State:VA
Practice Address - Zip Code:22046
Practice Address - Country:US
Practice Address - Phone:703-534-4393
Practice Address - Fax:703-992-8158
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-03
Last Update Date:2021-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101235397207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA001035978Medicaid
VA001035978Medicaid
VAG02352A01Medicare PIN