Individual
DUC THANH NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
17 LANSING ST STE 302, AUBURN, NY 13021-1983
(315) 567-0540
(315) 567-0334
Mailing address
17 LANSING ST, AUBURN, NY 13021-1983
(315) 255-7576
(315) 702-8393
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
23 013181
NY
363AM0700X
Medical Physician Assistant
Primary
013181
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03142665
—
NY
Enumeration date
04/28/2009
Last updated
01/07/2025
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