Provider Demographics
NPI:1932627254
Name:NGUYEN, RAYMOND (MS, OTR/L, CHT)
Entity type:Individual
Prefix:
First Name:RAYMOND
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:M
Credentials:MS, OTR/L, CHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1636 3RD AVE # 144
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10128-3622
Mailing Address - Country:US
Mailing Address - Phone:917-337-6914
Mailing Address - Fax:
Practice Address - Street 1:250 W 54TH ST STE 805
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-5558
Practice Address - Country:US
Practice Address - Phone:917-337-6914
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-09-07
Last Update Date:2024-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ46TR00784800225X00000X
NY021455225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist