Provider Demographics
NPI:1457109001
Name:NGUYEN, BICH VAN THI
Entity Type:Individual
Prefix:
First Name:BICH
Middle Name:VAN THI
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 1:80 ELLIOTT ST
Mailing Address - Street 2:
Mailing Address - City:DANVERS
Mailing Address - State:MA
Mailing Address - Zip Code:01923-3439
Mailing Address - Country:US
Mailing Address - Phone:469-688-9978
Mailing Address - Fax:
Practice Address - Street 1:63 STATION LNDG
Practice Address - Street 2:
Practice Address - City:MEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02155-5192
Practice Address - Country:US
Practice Address - Phone:781-393-5367
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-05-08
Last Update Date:2024-05-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program