Individual
DR. VIVIAN RISMONDO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
6569 N CHARLES ST, STE 505, BALTIMORE, MD 21204-6831
(443) 849-8084
(443) 849-6817
Mailing address
PO BOX 418953, BOSTON, MA 02241-8953
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
D43499
MD
2084N0400X
Neurology Physician
D43499
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
762851000
—
MD
01
—
KJ54GB/53000103
CAREFIRST MARYLAND GBMC
MD
01
—
S1410003
CAREFIRST REGIONAL GBMC
MD
Enumeration date
06/04/2006
Last updated
10/19/2011
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