Provider Demographics
NPI:1245233436
Name:VIGLIOTTI, DONALD J (MD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:J
Last Name:VIGLIOTTI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:11279 PERRY HWY
Mailing Address - Street 2:STE 450
Mailing Address - City:WEXFORD
Mailing Address - State:PA
Mailing Address - Zip Code:15090-9303
Mailing Address - Country:US
Mailing Address - Phone:724-933-1100
Mailing Address - Fax:724-933-1160
Practice Address - Street 1:1 NOLTE DR
Practice Address - Street 2:STE 107
Practice Address - City:KITTANNING
Practice Address - State:PA
Practice Address - Zip Code:16201-7111
Practice Address - Country:US
Practice Address - Phone:724-548-2283
Practice Address - Fax:724-543-4380
Is Sole Proprietor?:No
Enumeration Date:2005-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
PAMD036888E208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA0011280480007Medicaid
PAB40788Medicare UPIN