Basic Information
| Provider Information | |||||||||
| NPI: | 1548392533 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | FALCO | ||||||||
| FirstName: | VIVIANA | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 3600 PRYTANIA STREET | ||||||||
| Address2: | SUITE 35 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 70115 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978315 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3715 PRYTANIA ST. | ||||||||
| Address2: | SUITE 400 | ||||||||
| City: | NEW ORLEANS | ||||||||
| State: | LA | ||||||||
| PostalCode: | 701153761 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5048978276 | ||||||||
| FaxNumber: | 5048978336 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/12/2007 | ||||||||
| LastUpdateDate: | 10/15/2013 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 025617 | LA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RC0000X | 25617 | LA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Cardiovascular Disease |
ID Information
| ID | Type | State | Issuer | Description | 04331 | 05 | LA | MEDICAID | 31580 | 01 | LA | CDS LICENSE | OTHER | BF8914562 | 01 | DEA NUMBER | OTHER |