Individual
JEFFREY VIVEIROS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
1672 S COUNTY TRL, EAST GREENWICH, RI 02818-5098
(401) 885-7546
Mailing address
1672 S COUNTY TRL, EAST GREENWICH, RI 02818-5098
(401) 885-7546
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
RN2285490
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050483739
TAX ID #
—
05
—
1740666932
—
RI
01
—
709004046
MEDICARE GROUP PTAN
RI
Enumeration date
08/11/2015
Last updated
09/11/2018
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