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General NPI Number Information
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NPI Number | 1720665607
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Entity Type | Individual
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Provider Name | PAULA MARIE VIVONA DPM
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Gender | Female
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Dates
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Enumeration Date | 03/26/2021
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Last Update Date | 04/28/2025
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Provider Practice Location Address
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Address Line | 3495 BAILEY AVE
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City | BUFFALO
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State | NY
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Zip | 14215-1129
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Country | US
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Telephone | 716-834-9200
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Fax |
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Provider Business Mailing Address
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Address Line | 107 FAIRTON MILLVILLE RD
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City | BRIDGETON
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State | NJ
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Zip | 08302-7167
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Country | US
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Telephone | 185-677-6397
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | N007391-01
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License Number State | NY
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