Provider Demographics
NPI:1134583453
Name:NGUYEN, HAN MAI THI (FNP)
Entity type:Individual
Prefix:
First Name:HAN
Middle Name:MAI THI
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:317 W 87TH ST
Mailing Address - Street 2:APT 3-E
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10024-2604
Mailing Address - Country:US
Mailing Address - Phone:310-701-4614
Mailing Address - Fax:
Practice Address - Street 1:222 E 34TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-4842
Practice Address - Country:US
Practice Address - Phone:310-701-4614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-12
Last Update Date:2017-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYF340571363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily