Individual
DR. TIEN HAC NGUYEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
210 N BELLE MEAD RD, EAST SETAUKET, NY 11733-3522
(631) 689-1400
(631) 689-1595
Mailing address
100 HIGHLANDS BLVD # 9, PORT JEFFERSON, NY 11777-2320
(631) 473-1320
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
206315-1
NY
207RI0011X
Interventional Cardiology Physician
206315-1
NY
363AM0700X
Medical Physician Assistant
206315
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02361842
—
NY
Enumeration date
04/06/2006
Last updated
03/05/2019
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