Provider Demographics
NPI:1427802032
Name:HUYNH, THERESA (NP)
Entity type:Individual
Prefix:
First Name:THERESA
Middle Name:
Last Name:HUYNH
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:86 OLD NEW BRUNSWICK RD APT 86A
Mailing Address - Street 2:
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-3895
Mailing Address - Country:US
Mailing Address - Phone:908-340-8544
Mailing Address - Fax:
Practice Address - Street 1:811 WASHINGTON RD
Practice Address - Street 2:
Practice Address - City:PARLIN
Practice Address - State:NJ
Practice Address - Zip Code:08859-1078
Practice Address - Country:US
Practice Address - Phone:848-444-1962
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-04-11
Last Update Date:2024-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ15054300363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily