Individual
JACQUELINE VIVIANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APN
Contact information
Practice address
150 BERGEN ST, NEWARK, NJ 07103-2496
(973) 972-5882
Mailing address
54 MAIN TER, BLOOMFIELD, NJ 07003-4012
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
26NJ00944300
NJ
Other
Enumeration date
08/08/2019
Last updated
03/24/2026
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