Provider Demographics
NPI:1033355821
Name:VIVIANO, LINDA ANN (MS, CCC-SLP)
Entity Type:Individual
Prefix:MRS
First Name:LINDA
Middle Name:ANN
Last Name:VIVIANO
Suffix:
Gender:F
Credentials:MS, CCC-SLP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2964 RUTH RD
Mailing Address - Street 2:
Mailing Address - City:WANTAGH
Mailing Address - State:NY
Mailing Address - Zip Code:11793-1032
Mailing Address - Country:US
Mailing Address - Phone:917-975-1916
Mailing Address - Fax:
Practice Address - Street 1:2964 RUTH RD
Practice Address - Street 2:
Practice Address - City:WANTAGH
Practice Address - State:NY
Practice Address - Zip Code:11793-1032
Practice Address - Country:US
Practice Address - Phone:917-975-1916
Practice Address - Fax:516-783-3008
Is Sole Proprietor?:No
Enumeration Date:2008-12-28
Last Update Date:2016-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY011857-1235Z00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes235Z00000XSpeech, Language and Hearing Service ProvidersSpeech-Language Pathologist