Individual ProviderVivian AjaeroNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2015 Grand Concourse, Bronx, NY 10453-4303(718) 583-7736(718) 618-0401PECOS EnrollmentBased on the most recent information from CMS, provider Vivian Ajaero is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1225928716Provider TypeIndividualFull NameAjaero, VivianCredentialNPGenderFemaleSole ProprietorNoEnumeration Date7/7/2025Last Updated7/7/2025Contact InformationPractice LocationPractice Address2015 Grand Concourse, Bronx, NY 10453-4303Phone(718) 583-7736Fax(718) 537-6180Mailing LocationMailing Address2626 Halperin Ave, Bronx, NY 10461-2631Phone(718) 618-0401Fax(347) 479-1303Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF357109New York