Organization
THAO NGUYEN NURSE PRACTITIONER IN PSYCHIATRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THAO NGUYEN NP (OWNER)
(631) 318-4004
Entity
Organization
Contact information
Practice address
12 FAIRWOOD LN, CORAM, NY 11727-3336
(631) 318-4004
(631) 318-6443
Mailing address
1070 MIDDLE COUNTRY RD STE 7-271, SELDEN, NY 11784-2580
(516) 398-6691
(631) 318-6443
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04591291
—
NY
Enumeration date
06/08/2020
Last updated
11/07/2023
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