Basic Information
Provider Information
NPI: 1801982202
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BURNS
FirstName: TIEN
MiddleName: T.
NamePrefix:  
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName: HOANG
OtherFirstName: TIEN
OtherMiddleName: THUY
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential: M.D.
OtherLastNameType: 1
Mailing Information
Address1: 111 COLCHESTER AVE
Address2: FLETCHER ALLEN HEALTH CARE (RADIOLOGY DEPT.)
City: BURLINGTON
State: VT
PostalCode: 054011473
CountryCode: US
TelephoneNumber: 8028472700
FaxNumber:  
Practice Location
Address1: 111 COLCHESTER AVE
Address2: FLETCHER ALLEN HEALTH CARE (RADIOLOGY DEPT.)
City: BURLINGTON
State: VT
PostalCode: 054011473
CountryCode: US
TelephoneNumber: 8028472700
FaxNumber:  
Other Information
ProviderEnumerationDate: 10/04/2006
LastUpdateDate: 02/26/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2085R0202X042-0011609VTY Allopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology

No ID Information.


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