Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204D00000X | Neuromusculoskeletal Medicine (NMM) | 269415 | NY |
NPI | 1225343361 |
---|---|
Provider Name | Dr. Trang Bichngoc Nguyen |
First Address | Southampton, NY 11968-5275 |
Second Address | Southampton, NY 11968-5275 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 12/08/2010 |
Last Update Date | 18/09/2013 |