Provider Demographics
NPI:1447368444
Name:VIVONA, VINCENT J (DO)
Entity type:Individual
Prefix:DR
First Name:VINCENT
Middle Name:J
Last Name:VIVONA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:147 ROUTE 37 W
Mailing Address - Street 2:
Mailing Address - City:TOMS RIVER
Mailing Address - State:NJ
Mailing Address - Zip Code:08755-8062
Mailing Address - Country:US
Mailing Address - Phone:732-240-3700
Mailing Address - Fax:732-240-1385
Practice Address - Street 1:147 ROUTE 37 W
Practice Address - Street 2:
Practice Address - City:TOMS RIVER
Practice Address - State:NJ
Practice Address - Zip Code:08755-8062
Practice Address - Country:US
Practice Address - Phone:732-240-3700
Practice Address - Fax:732-240-1385
Is Sole Proprietor?:No
Enumeration Date:2006-08-29
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NJMB31605207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ15439OtherUNIVERSITY HEALTH PLAN
NJ1K4986OtherHEALTHNET
NJ2311441OtherAETNA
NJP493981OtherOXFORD
NJ0098778000OtherAMERIHEALTH
NJ0325066-004OtherCIGNA
NJ2198732OtherGHI
NJ1392177OtherUNITED HEALTHCARE
NJ1040483OtherHORIZON NJ HEALTH PLAN
NJ221083OtherUNIFORM SERVICE FAMILY
NJ4681002Medicaid
NJ1040483OtherHORIZON NJ HEALTH PLAN
NJ1392177OtherUNITED HEALTHCARE