Provider Demographics
NPI:1831545193
Name:NGUYEN, FRANK (DO)
Entity type:Individual
Prefix:
First Name:FRANK
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1715 E 13TH ST # 4
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1901
Mailing Address - Country:US
Mailing Address - Phone:718-258-2588
Mailing Address - Fax:718-258-2205
Practice Address - Street 1:1715 E 13TH ST # 4
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1901
Practice Address - Country:US
Practice Address - Phone:718-258-2588
Practice Address - Fax:718-258-2205
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-05
Last Update Date:2021-08-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY3122992081S0010X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation
No2081S0010XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY312299OtherLICENSE