Organization
MOON ADULT HEALTH NP PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NGUYET DUONG (NP)
(718) 286-9176
Entity
Organization
Contact information
Practice address
8635 QUEENS BLVD STE 1B, ELMHURST, NY 11373-4408
(718) 286-9176
Mailing address
3336 71ST ST, JACKSON HEIGHTS, NY 11372-1057
(718) 286-9176
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03435343
—
NY
Enumeration date
02/19/2021
Last updated
02/19/2021
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