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Individual

AVY NGUYEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
251 TURN OF RIVER RD, STAMFORD, CT 06905-1320
(203) 916-5409
Mailing address
21 SYCAWAY ST, WEST HAVEN, CT 06516-1222
(203) 690-8011

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
5143
CT
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
5143
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
078290197
DRIVER LICENSE
CT
Enumeration date
02/07/2019
Last updated
02/07/2019
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