Provider Demographics
NPI:1841382124
Name:WASMUHT-PERROUD, VIVIAN ARIANE (MD DMD)
Entity Type:Individual
Prefix:DR
First Name:VIVIAN
Middle Name:ARIANE
Last Name:WASMUHT-PERROUD
Suffix:
Gender:F
Credentials:MD DMD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:530 1ST AVE
Mailing Address - Street 2:9QQ
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-6402
Mailing Address - Country:US
Mailing Address - Phone:212-263-7552
Mailing Address - Fax:
Practice Address - Street 1:530 1ST AVE
Practice Address - Street 2:9QQ
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-6402
Practice Address - Country:US
Practice Address - Phone:212-263-7552
Practice Address - Fax:212-263-6931
Is Sole Proprietor?:No
Enumeration Date:2006-09-28
Last Update Date:2016-11-01
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD071813L204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery