Individual
BRIAN VINCENT VIVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2010 W 38TH ST UPPR LEVEL, ERIE, PA 16508-2004
(814) 866-6835
(814) 866-6837
Mailing address
1 LECOM PL, ERIE, PA 16505-2571
(814) 868-2522
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
OS015368
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
003151031
HIGHMARK
PA
05
—
1030065750001
—
PA
01
—
P01637821
RR MEDICARE
PA
Enumeration date
07/10/2009
Last updated
05/04/2023
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