Provider Demographics
NPI:1043265960
Name:LITOVSKY, VIVIANA G (PHD)
Entity Type:Individual
Prefix:DR
First Name:VIVIANA
Middle Name:G
Last Name:LITOVSKY
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:792 CHIMNEY ROCK RD STE C
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:NJ
Mailing Address - Zip Code:08836-2271
Mailing Address - Country:US
Mailing Address - Phone:732-356-8855
Mailing Address - Fax:732-356-0067
Practice Address - Street 1:792 CHIMNEY ROCK RD STE C
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:NJ
Practice Address - Zip Code:08836-2271
Practice Address - Country:US
Practice Address - Phone:732-356-8855
Practice Address - Fax:732-356-0067
Is Sole Proprietor?:No
Enumeration Date:2006-05-23
Last Update Date:2021-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ35SI00254600103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
027105Medicare ID - Type Unspecified
S79861Medicare UPIN