Individual
MARK J VANVIEGEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ENP/FNP-BC
Contact information
Practice address
266 ELMWOOD AVE STE 428, BUFFALO, NY 14222-2202
(919) 426-1756
Mailing address
266 ELMWOOD AVE, PMG 428, BUFFALO, NY 14222
(919) 426-1756
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
005002286
NC
363L00000X
Nurse Practitioner
14586
CT
363L00000X
Nurse Practitioner
4053567
KY
363L00000X
Nurse Practitioner
F350568
NY
363L00000X
Nurse Practitioner
Primary
F350568-01
NY
363LA2100X
Acute Care Nurse Practitioner
NP3029682
FL
363LF0000X
Family Nurse Practitioner
11846
WI
363LF0000X
Family Nurse Practitioner
149084
NC
363LF0000X
Family Nurse Practitioner
RN10029872
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
NP0297
—
SC
01
—
P00398888
RAILROAD MEDICARE
NC
Enumeration date
10/11/2005
Last updated
04/29/2026
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