Individual
DR. CHARLES PHONG NGUYEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2390 MORGAN AVE, BRONX, NY 10469-5720
(646) 772-1566
Mailing address
2390 MORGAN AVE, BRONX, NY 10469-5720
(646) 772-1566
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
X008941
NY
111NI0013X
Independent Medical Examiner Chiropractor
X008941
NY
111NR0400X
Rehabilitation Chiropractor
X008941
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02132236
—
NY
Enumeration date
04/11/2007
Last updated
04/21/2015
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