Provider Demographics
NPI:1831471978
Name:VIANI, PAMELA B (ANP)
Entity Type:Individual
Prefix:
First Name:PAMELA
Middle Name:B
Last Name:VIANI
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 STIRRUP LN
Mailing Address - Street 2:
Mailing Address - City:PLEASANT VALLEY
Mailing Address - State:NY
Mailing Address - Zip Code:12569-7349
Mailing Address - Country:US
Mailing Address - Phone:914-475-6373
Mailing Address - Fax:
Practice Address - Street 1:21 STIRRUP LN
Practice Address - Street 2:
Practice Address - City:PLEASANT VALLEY
Practice Address - State:NY
Practice Address - Zip Code:12569-7349
Practice Address - Country:US
Practice Address - Phone:914-475-6373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-14
Last Update Date:2011-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY305871363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health