Provider Demographics
NPI:1073351243
Name:NGUYEN, JASMINE YEN-BINH
Entity type:Individual
Prefix:MISS
First Name:JASMINE
Middle Name:YEN-BINH
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 TUDOR CITY PL APT 1414
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10017-6872
Mailing Address - Country:US
Mailing Address - Phone:832-585-4128
Mailing Address - Fax:
Practice Address - Street 1:3651 BRUCKNER BLVD
Practice Address - Street 2:6TH FL
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10461
Practice Address - Country:US
Practice Address - Phone:718-823-9227
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-19
Last Update Date:2024-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010028152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist