Provider Demographics
NPI:1588446983
Name:NGAI, VIVIEN MEN
Entity type:Individual
Prefix:
First Name:VIVIEN
Middle Name:MEN
Last Name:NGAI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21110 18TH AVE APT 2F
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1501
Mailing Address - Country:US
Mailing Address - Phone:718-578-7455
Mailing Address - Fax:
Practice Address - Street 1:21110 18TH AVE APT 2F
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1501
Practice Address - Country:US
Practice Address - Phone:718-578-7455
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-19
Last Update Date:2023-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY002218-01101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health