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General NPI Number Information
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NPI Number | 1992897342
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Entity Type | Individual
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Provider Name | MAILYN THI NGUYEN PHYSICAL THERAPIST
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Gender | Female
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Dates
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Enumeration Date | 09/29/2006
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Last Update Date | 08/26/2008
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Provider Practice Location Address
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Address Line | 570 EGG HARBOR RD
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City | SEWELL
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State | NJ
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Zip | 08080-2359
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Country | US
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Telephone | 856-589-3256
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Fax |
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Provider Business Mailing Address
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Address Line | 45 LONG BOW DR
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City | SEWELL
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State | NJ
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Zip | 08080-1671
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Country | US
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Telephone | 215-313-2240
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 40QA01218300
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License Number State | NJ
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