Provider Demographics
NPI:1699873711
Name:VIEAU, MAUREEN CECELIA (RPH)
Entity type:Individual
Prefix:MRS
First Name:MAUREEN
Middle Name:CECELIA
Last Name:VIEAU
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:MISS
Other - First Name:MAUREEN
Other - Middle Name:CECELIA
Other - Last Name:WHITE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:602 CRAWFORD AVE
Mailing Address - Street 2:
Mailing Address - City:SYRACUSE
Mailing Address - State:NY
Mailing Address - Zip Code:13224-1924
Mailing Address - Country:US
Mailing Address - Phone:315-446-9981
Mailing Address - Fax:315-446-3547
Practice Address - Street 1:800 IRVING AVE
Practice Address - Street 2:
Practice Address - City:SYRACUSE
Practice Address - State:NY
Practice Address - Zip Code:13210-2716
Practice Address - Country:US
Practice Address - Phone:315-425-4400
Practice Address - Fax:315-425-2452
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040423-1183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist