Healthcare Provider Details

I. General information

NPI: 1255482162
Provider Name (Legal Business Name): VIVIENNE MONACHINO HAYNE M.D., J.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/16/2007
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1040 CALHOUN ST
NEW ORLEANS LA
70118-5914
US

IV. Provider business mailing address

PO BOX 15650
NEW ORLEANS LA
70175-5650
US

V. Phone/Fax

Practice location:
  • Phone: 504-813-9964
  • Fax: 504-314-1787
Mailing address:
  • Phone: 504-813-9964
  • Fax: 504-314-1787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number10574R
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: