Bea, Vivian Jolley

Bea, Vivian Jolley is an individual health care provider with primary practice located at 506 6Th St , Brooklyn NY 11215-3609. She recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as her primary health care specialty. Bea, Vivian Jolley can be contacted via phone (718) 780-3288.

Contact Information

Primary practice address
506 6Th St Brooklyn NY 11215-3609
Phone: (718) 780-3288
Fax: (718) 780-3154
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X Q9291 Texas
Allopathic & Osteopathic Physicians / Surgery 208600000X LL32911 South Carolina
Allopathic & Osteopathic Physicians / Surgery 208600000X 25MA10160900 New Jersey
Allopathic & Osteopathic Physicians / Surgery 208600000X 300153-01 New York

Profile Details

NPI number 1003127366
LBN Legal business name Bea, Vivian Jolley
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 1st, 2010
Last updated Sep 11th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1003127366 NPPES
Texas MEDICAID 366461701

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