Provider Demographics
NPI:1235268533
Name:NGUYEN, VIVIAN T (PT)
Entity Type:Individual
Prefix:
First Name:VIVIAN
Middle Name:T
Last Name:NGUYEN
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 1:13 HILLS RD
Mailing Address - Street 2:
Mailing Address - City:HOOKSETT
Mailing Address - State:NH
Mailing Address - Zip Code:03106-2189
Mailing Address - Country:US
Mailing Address - Phone:603-622-3740
Mailing Address - Fax:
Practice Address - Street 1:13 HILLS RD
Practice Address - Street 2:
Practice Address - City:HOOKSETT
Practice Address - State:NH
Practice Address - Zip Code:03106-2189
Practice Address - Country:US
Practice Address - Phone:603-622-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-04
Last Update Date:2010-12-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH2740225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH30394966Medicaid
NHP00463023OtherMVP
NH08Y011606NH01OtherANTHEM BC/BS
NH7585894OtherAETNA
NH7585894OtherAETNA