Healthcare Provider Details

I. General information

NPI: 1407566482
Provider Name (Legal Business Name): KRISTEN JOY VIEAU AUD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2022
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

240 W SENECA ST STE 8
MANLIUS NY
13104-2539
US

IV. Provider business mailing address

240 W SENECA ST STE 8
MANLIUS NY
13104-2539
US

V. Phone/Fax

Practice location:
  • Phone: 315-652-2025
  • Fax: 315-682-2756
Mailing address:
  • Phone: 315-652-2025
  • Fax: 315-682-2756

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License Number003159
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number14000070451
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: