Individual
VIVIAN WIATER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
333 CEDAR ST, STE TMP 4, NEW HAVEN, CT 06510-3206
(203) 737-2096
Mailing address
333 CEDAR ST, STE TMP 4, NEW HAVEN, CT 06510-3206
(203) 737-2096
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
3393
CT
Other
Enumeration date
07/28/2015
Last updated
04/24/2017
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