Provider Demographics
NPI:1114154473
Name:SALVACION, VIVIAN PABLO (PT)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:PABLO
Last Name:SALVACION
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:270 E GRASSY SPRAIN RD
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-2307
Mailing Address - Country:US
Mailing Address - Phone:914-961-9185
Mailing Address - Fax:
Practice Address - Street 1:270 E GRASSY SPRAIN RD
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-2307
Practice Address - Country:US
Practice Address - Phone:914-961-9185
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-06-15
Last Update Date:2009-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY010067-1225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist