Organization
NICHOLAS J. VIVIANO, MD, LLC
Active
Organization
NICHOLAS J. VIVIANO, MD, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. NICHOLAS JOSEPH VIVIANO MD (CEO)
(985) 893-9464
Entity
Organization
Contact information
Practice address
7031 HIGHWAY 190 EAST SERVICE RD, COVINGTON, LA 70433-4955
(985) 893-9464
(985) 893-9465
Mailing address
PO BOX 1259, MANDEVILLE, LA 70470-1259
(985) 893-9464
(985) 893-9465
Taxonomy
Speciality
Code
Description
License number
State
207NS0135X
Procedural Dermatology Physician
Primary
015859
LA
Other
Enumeration date
12/05/2007
Last updated
12/05/2007
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