MEDICARE: MS. VIVIANNE REGINA LAURA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist

General Provider Information

NPI Number	:	1790046803
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. VIVIANNE REGINA LAURA

Provider Business Mailing Address
First Line	:	14 BAKER ST
Second Line	:	APT. D
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-8035
Country	:	US
Telephone Number	:	917-361-2713
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 BAKER ST
Second Line	:	APT. D
City	:	WEST BABYLON
State	:	NY
Zip	:	11704-8035
Country	:	US
Telephone Number	:	917-361-2713
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/05/2012
Last Update Date	:	06/05/2012

Similar Medicare Providers

1497832083 — DR. LYSA CHARLES MD
Practice Location Address:

2101 E JEFFERSON ST PPQA MEDICARE COMPLIANCE UNT 6 WEST , KAISER PERMANENTE MID ATLANTIC PERMANENTE MEDICAL GROUP
ROCKVILLE, MD
20852-4908

Practice Phone: 301-816-6660
Practice Fax: 301-816-6308

1619975018 — DR. JOHN JOSEPH RAIO D.C.
Practice Location Address:

333 PASSAIC AVE
WEST CALDWELL, NJ
07006-8035

Practice Phone: 973-808-8485
Practice Fax: 973-808-2922

1588035539 — SAMANTHA LYNN HOULE ATC
Practice Location Address:

4878 SAND STONE LN , APT 108
WEST PALM BEACH, FL
33417-8035

Practice Phone: 715-410-0880
Practice Fax:

1578568705 — DR. RONALD REPLOGLE D.P.M.
Practice Location Address:

578 SUNRISE HWY
WEST BABYLON, NY
11704-6003

Practice Phone: 631-893-7030
Practice Fax: 631-893-7066

1457357097 — DR. LAURA CORSELLO M.D.
Practice Location Address:

580 SUNRISE HWY
WEST BABYLON, NY
11704-6003

Practice Phone: 631-422-9355
Practice Fax: 631-669-8763

1588661615 — DR. CORY A. MUSCARA M.D.
Practice Location Address:

580 SUNRISE HWY
WEST BABYLON, NY
11704-6003

Practice Phone: 631-422-9355
Practice Fax: 631-669-8763

Directions to “ MS. VIVIANNE REGINA LAURA ” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.