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General NPI Number Information
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NPI Number | 1740067164
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Entity Type | Individual
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Provider Name | VIVIEN VARGA FNP
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Gender | Female
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Dates
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Enumeration Date | 09/11/2023
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Last Update Date | 09/11/2023
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Provider Practice Location Address
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Address Line | 10 ROOSEVELT AVE
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City | PORT JEFFERSON STATION
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State | NY
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Zip | 11776-3393
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Country | US
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Telephone | 631-886-2844
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 523
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City | SHIRLEY
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State | NY
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Zip | 11967-0523
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Country | US
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Telephone | 631-681-7885
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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 | 364SF0001X
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Taxonomy Name | Family Health Clinical Nurse Specialist
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License Number | F352110-01
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License Number State | NY
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