Healthcare Provider Details

I. General information

NPI: 1235924796
Provider Name (Legal Business Name): VIVIANA IMMACOLATA ALLAHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/14/2025
Last Update Date: 08/10/2026
Certification Date: 08/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8435 256TH ST
FLORAL PARK NY
11001-1001
US

IV. Provider business mailing address

16635 20TH RD
WHITESTONE NY
11357-4001
US

V. Phone/Fax

Practice location:
  • Phone: 347-487-6789
  • Fax:
Mailing address:
  • Phone: 917-485-0388
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: