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Individual

DR. VIVIAN JOLLEY BEA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3288
(718) 780-3154
Mailing address
506 6TH ST, BROOKLYN, NY 11215-3609
(718) 780-3288
(718) 780-3154

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
25MA10160900
NJ
208600000X
Surgery Physician
Primary
300153-01
NY
208600000X
Surgery Physician
LL32911
SC
208600000X
Surgery Physician
Q9291
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
366461701
TX
Enumeration date
07/01/2010
Last updated
02/13/2025
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