Provider Demographics
NPI:1487096327
Name:GUZMAN, VIVIANE PATRICIA (MS SPED)
Entity type:Individual
Prefix:MRS
First Name:VIVIANE
Middle Name:PATRICIA
Last Name:GUZMAN
Suffix:
Gender:F
Credentials:MS SPED
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14404 37TH AVE APT 2L
Mailing Address - Street 2:
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11354-5903
Mailing Address - Country:US
Mailing Address - Phone:347-256-3535
Mailing Address - Fax:
Practice Address - Street 1:14404 37TH AVE APT 2L
Practice Address - Street 2:
Practice Address - City:FLUSHING
Practice Address - State:NY
Practice Address - Zip Code:11354-5903
Practice Address - Country:US
Practice Address - Phone:347-256-3535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-19
Last Update Date:2013-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
No171M00000XOther Service ProvidersCase Manager/Care Coordinator