National Provider Identifier

Vivian L Condello, RN, MS, FNP, IBCLC

Vivian L Condello, RN, MS, FNP, IBCLC is listed in the NPPES registry with a primary specialty of Family Nurse Practitioner in Brockport, NY and a listed phone number of (585) 395-2414.

NPI 1538374129Brockport, NYFamily Nurse Practitioner

Profile Overview

NPI
1538374129
Provider Type
Individual
Primary Specialty
Family Nurse Practitioner
Enumeration Date
May 14, 2007
Last Updated
February 04, 2022

Practice Location

  • 350 New Campus Dr
  • Hazen Hall
  • Brockport, NY 14420-2997

Phone: (585) 395-2414

Mailing Address

  • 148 Clooney Dr
  • Henrietta, NY 14467-8902

Specialties

  • Family Nurse Practitioner (363LF0000X)
  • Lactation Consultant (Registered Nurse) (163WL0100X)
Full Record
NPI
1538374129
Entity Type
Individual
Last Name
Condello
First Name
Vivian
Middle Name
L
Name Prefix
Mrs.
Credential
RN, MS, FNP, IBCLC
Mailing Street Address
148 Clooney Dr
Mailing City
Henrietta
Mailing State
NY
Mailing ZIP Code
14467-8902
Mailing Country
US
Mailing Phone
(585) 334-4049
Practice Street Address
350 New Campus Dr
Practice Address Line 2
Hazen Hall
Practice City
Brockport
Practice State
NY
Practice ZIP Code
14420-2997
Practice Country
US
Practice Phone
(585) 395-2414
Practice Fax
(585) 395-2559
Enumeration Date
May 14, 2007
Last Updated
February 04, 2022
Sex
Female
Sole Proprietor
No
Certification Date
February 04, 2022
updated_by_file
npidata_pfile_20050523-20260308.csv
Taxonomies
Family Nurse Practitioner (363LF0000X), Lactation Consultant (Registered Nurse) (163WL0100X)
Other Identifiers
RB7031 (NY, Medicare Ptan)