Doctor Name: | MR. DAVID VIERA |
NPI Number: | 1174774145 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICIAN ASSISTANT |
License Number: | 001211-1 |
Business Practice Address: | 1065 Tooker Ave. West Babylon, NY - 117045047 |
Business Phone Number: | 6315871029 |
Business Fax Number: | |
Mailing Address: | 1065 Tooker Ave, West Babylon NEW YORK |
State: | NY |
Postal Code: | 117045047 |
Phone Number: | 6315871029 |
Fax Number: | 6315871029 |
NPI Enumeration Date: | 10/08/2008 |
NPI Last Update Date: | 10/08/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 001211-1 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |