MS. Vivianne Regina Laura
NPI #1790046803 in West Babylon, New York
Provider Information
- NPI Number
- 1790046803
- Entity Type
- Individual
- Name
- MS. Vivianne Regina Laura
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Enumeration Date
- Jun 5, 2012
- Last Updated
- Jun 5, 2012
Practice Location
- Address
- 14 BAKER ST
- Address 2
- APT. D
- City
- West Babylon
- State
- New York
- ZIP Code
- 11704-8035
- Phone
- (917) 361-2713
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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