Condello, Vivian L

Condello, Vivian L is an individual health care provider with primary practice located at 350 New Campus Dr Hazen Hall, Brockport NY 14420-2997. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Lactation Consultant, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Condello, Vivian L can be contacted via phone (585) 395-2414.

Contact Information

Primary practice address
350 New Campus Dr Hazen Hall Brockport NY 14420-2997
Phone: (585) 395-2414
Fax: (585) 395-2559
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Lactation Consultant 163WL0100X 252168-1 New York
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X F332995-1 New York

Profile Details

NPI number 1538374129
LBN Legal business name Condello, Vivian L
Credentials RN, MS, FNP, IBCLC
Entity Individual
Sole proprietor 1 No
Enumeration date May 14th, 2007
Last updated Feb 4th, 2022 - about 2 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 1538374129 NPPES
New York Other RB7031 MEDICARE PTAN

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