Basic Information
Provider Information | |||||||||
NPI: | 1740395607 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | NGUYEN | ||||||||
FirstName: | HUNG | ||||||||
MiddleName: | DINH | ||||||||
NamePrefix: | DR. | ||||||||
NameSuffix: |   | ||||||||
Credential: | MD | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: |   | ||||||||
OtherFirstName: |   | ||||||||
OtherMiddleName: |   | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: |   | ||||||||
OtherLastNameType: |   | ||||||||
Mailing Information | |||||||||
Address1: | 19 WEST AVE STE 201 | ||||||||
Address2: | SARATOGA HOSPITAL PULMONOLOGY AND SLEEP MEDICINE | ||||||||
City: | SARATOGA SPRINGS | ||||||||
State: | NY | ||||||||
PostalCode: | 128666049 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5186934635 | ||||||||
FaxNumber: |   | ||||||||
Practice Location | |||||||||
Address1: | 19 WEST AVE STE 201 | ||||||||
Address2: | SARATOGA HOSPITAL PULMONOLOGY AND SLEEP MEDICINE | ||||||||
City: | SARATOGA SPRINGS | ||||||||
State: | NY | ||||||||
PostalCode: | 128666049 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 5186934635 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 08/20/2006 | ||||||||
LastUpdateDate: | 02/24/2017 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | M | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: |   |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 241363 | NY | Y |   | Allopathic & Osteopathic Physicians | Internal Medicine |   | 208M00000X | 241363 | NY | N |   | Allopathic & Osteopathic Physicians | Hospitalist |   |
ID Information
ID | Type | State | Issuer | Description | 02806673 | 05 | NY |   | MEDICAID |