1831504182 NPI number — MS. SYLVIA NGUYEN ANP

Table of content: MS. SYLVIA NGUYEN ANP (NPI 1831504182)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1831504182 NPI number — MS. SYLVIA NGUYEN ANP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
NGUYEN
Provider First Name:
SYLVIA
Provider Middle Name:
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
ANP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1831504182
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/03/2017
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1760 E RIVER RD
Provider Second Line Business Mailing Address:
STE. # 350
Provider Business Mailing Address City Name:
TUCSON
Provider Business Mailing Address State Name:
AZ
Provider Business Mailing Address Postal Code:
85718-5877
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
520-519-7775
Provider Business Mailing Address Fax Number:
520-519-7775

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2730 S VAL VISTA DR
Provider Second Line Business Practice Location Address:
BLDG.#13, SUITE 177
Provider Business Practice Location Address City Name:
GILBERT
Provider Business Practice Location Address State Name:
AZ
Provider Business Practice Location Address Postal Code:
85295-1675
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
480-394-0200
Provider Business Practice Location Address Fax Number:
480-394-0202
Provider Enumeration Date:
06/25/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 363L00000X , with the licence number:  AP5655 , registered in the state of AZ ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 938670 , issued by the state of ( AZ ) . This identifiers is of the category "MEDICAID".




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