Individual
MS. ADRIENNE M. VIVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
375 SEGUINE AVE, STATEN ISLAND, NY 10309-3932
(718) 226-2377
Mailing address
64 LAREDO AVE, STATEN ISLAND, NY 10312-3430
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
008946
NY
363AS0400X
Surgical Physician Assistant
25MP00101800
NJ
Other
Enumeration date
01/15/2009
Last updated
03/30/2009
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