Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LG0600X | Nurse Practitioner - Gerontology | 340636-1 | NY |
NPI | 1053489054 |
---|---|
Provider Name | Ha T Nguyen |
First Address | New York, NY 10119 |
Second Address | New York, NY 10119 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 30/11/2006 |
Last Update Date | 08/07/2007 |