Provider Demographics
NPI:1831469360
Name:KAMIENNY, AVIVA (NP)
Entity type:Individual
Prefix:
First Name:AVIVA
Middle Name:
Last Name:KAMIENNY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14905 79TH AVE
Mailing Address - Street 2:APT. 321
Mailing Address - City:FLUSHING
Mailing Address - State:NY
Mailing Address - Zip Code:11367-3855
Mailing Address - Country:US
Mailing Address - Phone:917-370-2505
Mailing Address - Fax:
Practice Address - Street 1:1810 HADDONFIELD BERLIN RD
Practice Address - Street 2:
Practice Address - City:CHERRY HILL
Practice Address - State:NJ
Practice Address - Zip Code:08003-3736
Practice Address - Country:US
Practice Address - Phone:856-795-3313
Practice Address - Fax:856-354-8780
Is Sole Proprietor?:No
Enumeration Date:2011-12-30
Last Update Date:2018-03-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY5865041163W00000X
NYF3605221363LX0001X
NY28 001478367A00000X
NJ25ME00063201367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No163W00000XNursing Service ProvidersRegistered Nurse
No363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology