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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