Organization
VIP MEDICAL GROUP OF NJ, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL NGUYEN MD (OWNER-AUTHORIZED OFFICIAL)
(212) 518-7874
Entity
Organization
Contact information
Practice address
342 HAMBURG TPKE STE 203, WAYNE, NJ 07470-2166
(347) 405-8160
(347) 405-8161
Mailing address
41 PARK AVE, SUITE#1C, NEW YORK, NY 10016-3486
(212) 518-7874
(347) 405-8161
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
25MA10140500
LICENSE
NJ
Enumeration date
07/30/2018
Last updated
07/30/2018
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