Individual
ALICIA VIVONA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN, PMHNP
Contact information
Practice address
127 W MAIN ST, RIVERHEAD, NY 11901-2801
(631) 727-4044
Mailing address
127 W MAIN ST, RIVERHEAD, NY 11901-2801
Taxonomy
Speciality
Code
Description
License number
State
163WP0808X
Psychiatric/Mental Health Registered Nurse
687250
NY
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
407302
NY
Other
Enumeration date
01/03/2025
Last updated
07/25/2025
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