Most Relevant Information
Provider Data
| NPI Number: | 1003485335 |
| Provider Name: | VIVICA SUMRAJIT RN |
| Entity Type: | Individual |
| Taxonomy Code: | 163W00000X |
| Specialty: | Registered Nurse |
| License Number: | 683460 |
Most Important Dates
| Enumeration Date: | 06/21/2021 |
| Last Updated: | 06/21/2021 |
Provider Practice Location
2488 GRAND CONCOURSE
BRONX
NY
104585203
Practice Location Phone/Fax
| Phone: | 2126955122 |
| Fax: |
Provider Mailing Location
9017 153RD ST
JAMAICA
NY
114325974
Provider Mailing Phone/Fax
| Phone: | 7183225286 |
| Fax: |