Healthcare Provider Details

I. General information

NPI: 1487096327
Provider Name (Legal Business Name): VIVIANE PATRICIA GUZMAN MS. SP.ED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2013
Last Update Date: 07/19/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14404 37TH AVE APT 2L
FLUSHING NY
11354-5903
US

IV. Provider business mailing address

14404 37TH AVE APT 2L
FLUSHING NY
11354-5903
US

V. Phone/Fax

Practice location:
  • Phone: 347-256-3535
  • Fax:
Mailing address:
  • Phone: 347-256-3535
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code171M00000X
TaxonomyCase Manager/Care Coordinator
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: