Viviane Marie Anne Etienne, M.D

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

185097 Issued in NY

Practice address

4011 Warren St
Elmhurst, NY 11373-1734

Phone

(718) 651-7175

NPI assigned

May 21, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• CMC Radiological Services PC

  dba St Vincents Catholic Medical Center

  • Diagnostic Radiology Physician
  • Elmhurst, NY
  • NPI 1093851990
  NPD (past)
• CMC Radiological Services PC

  dba St Vincents Catholic Medical Center

  • Diagnostic Radiology Physician
  • Jamaica, NY
  • NPI 1285780502
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1179705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1699983585",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8 WILLOWBROOK LN",
            "city": "FREEPORT",
            "state": "NY",
            "postal_code": "115201327",
            "telephone_number": "516-665-8139"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4011 WARREN ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731734",
            "telephone_number": "718-651-7175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ETIENNE",
        "first_name": "VIVIANE",
        "middle_name": "MARIE ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-05-21",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NY",
            "license": "185097",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01467289",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Frank Estrada, M.D.
• Gerard Agustin Estrella
• Omayra Estrella
• Angelique Esver, PT, DPT
• Christopher Etienne
• Natasha Evanson, MSN, FNP-BC, APRN
• Evergreen Enrichment Center LLC
• Everyoung Pharmacy Inc
• Ewz Optical Corp (Cohen's Fashion Optical)
• Eyes & Optics Elmhurst Inc

• Internal Medicine Physician in Elmhurst, NY
• Providers in Elmhurst, NY by specialty
• Internal Medicine Physician in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.