Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 225XG0600X | Occupational Therapist - Gerontology | 0138651 | NY |
Y | 225XP0200X | Occupational Therapist - Pediatrics | 0138651 | NY |
NPI | 1275819237 |
---|---|
Provider Name | My-Ngoc Nguyen |
First Address | Brooklyn, NY 11209-3238 |
Second Address | Long Island City, NY 11106-2329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/10/2011 |
Last Update Date | 22/10/2011 |